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Dr K K Aggarwal

Padma Shri and Dr B C Roy National Awardee

5 Steps to lower risk of Alzheimer’s disease

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  1. Maintain a healthy weight.
  2. Check your waistline.
  3. Eat mindfully. Emphasize colorful, vitamin-packed vegetables and fruits; whole grains; fish, lean poultry, tofu, and beans and other legumes as protein sources plus healthy fats. Cut down on unnecessary calories from sweets, sodas, refined grains like white bread or white rice, unhealthy fats, fried and fast foods, and mindless snacking. Keep a close eye on portion sizes, too.
  4. Exercise regularly. Aim for 2½ to 5 hours weekly of brisk walking or try a vigorous exercise like jogging for half that time.

Keep a watch on your cholesterol, triglycerides, blood pressure, and blood sugar numbers.

(Source: Harvard)

What is the significance of a Tilak?

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The Tilak is not merely a beauty-enhancing mark, or a sign of religiosity. Hindu cultural traditions have given a significant place to wisdom in life. Life’s journey is guided by wisdom, which leads us through evolution of life towards salvation. If a man loses everything in his life but has his wisdom, he can recreate everything he has lost.

In Gayatri Mantra we chant, “May my Wisdom be enlightened and purified”. The worship that has been revered in the Vedas is symbolized in the Tilak. The seat of wisdom is the head and since the forehead is its front part, we worship wisdom by placing the Tilak on the forehead.

A Tilak is the ‘third eye’ in a manner of speaking. It is a divine eye which when ‘opened’ by divine knowledge shows the way to self-realization. Lord Shiva destroyed Kamadeva with his third eye, so too, we may destroy our desires and evil elements by striving for knowledge.Disclaimer: The views expressed in this write up are entirely my own

Righteousness and truthfulness

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  • When you cough or sneeze, you tend to expel out respiratory waste, which can be droplets (larger than 5 micron) or airborne droplets less than 5 micron; both have different clinical implications.
  • Droplets remain suspended in the air for a limited period only and exposure of less than 3 feet is usually required for human to human transmission of droplet-borne respiratory organisms. In flu, this can be up to 6 feet. The examples of droplet infections are meningitis, influenza, rubella (German measles), etc.
  • No precaution needs to be taken by a person who is 6-10 feet away from the patient but if a person is sitting or working at even 3-6 feet distance, the non-coughing person should wear a simple mask.
  • Airborne droplet nuclei that carry respiratory secretions smaller than 5 microns can remain suspended in the air for extended period and can cause infections to people who are standing even more than 10 feet away. The examples of airborne droplet nuclei infections are TB, measles, chickenpox and SARS.
  • Patients with these diseases should be placed in an isolation room and all healthcare personnel who are looking after these patients must use a safe N95 mask.
  • In normal house with windows opened, there is a constant exchange of air, which prevents spread of infections but in AC setups with no air exchange, the infections can spread from one person to another.
  • When sitting in an air-conditioned atmosphere, the setting of the AC should be such that the same air is not circulated and fresh air is allowed to exchange. Split ACs, therefore, are more dangerous than the window ACs.
  • In an office with split AC, if one employee is suffering from any of the droplet nuclei disease, he/she can transmit infection to others. Therefore, patients with confirmed TB, measles, chickenpox and SARS should not be allowed to work in split AC atmosphere.

Am I a spiritual seeker?

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Every one cannot be a spiritual seeker. In fact, majority is not interested in seeking spiritual knowledge and they keep themselves busy in the worldly desires. To become a good seeker, one needs to acquire many qualities.

In Bhagavad Gita, Arjuna, in a state of disturbed mind, sought guidance from Lord Krishna. In Katha Upanishad, Nachiketa, as a healthy seeker, learned the knowledge of life after death from Yama.

Katha Upanishad described in detail the qualities of a seeker in Nachiketa.

The story goes as under: Vajashrava sage performed a sacrifice in which he was required to give away all his worldly possessions. His son Nachiketa saw that the cows given in the donations were all old. Such charity was not going to give his father any merits. Feeling disturbed by the inappropriateness of his fathers observance of the sacrifice, Nachiketa asked to whom was he given. The sage ignored him twice, but on third asking, the irritated sage said in anger, “Unto Yama, I give thee.” Whereupon Nachiketa went to the abode of Yama, and, finding him absent, waited there for three days and nights. Yama on his return offered to grant him three wishes.

Nachiketa wished the following:

  1. To be allowed to return to his father alive, and that his father not be angry with him
  2. To be instructed about fire sacrifice
  3. To be given knowledge about life after death.

Yama granted the first wish immediately. In answer to Nachiketas second question, Yama named performance of a special fire-sacrifice after Nachiketa. Before answering the third question, Yama tested Nachiketa, offering him all sorts of worldly pleasures instead, but Nachiketa insisted. And then Yama taught him about life after death.

The properties of true seeker therefore are:

  1. Righteousness and truthfulness: Nachiketa did not agree with his father as his (father’s) act was not based on Dharma.
  2. Persistence: He waited for three days to meet Yama.
  3. Compassion and forgiveness: The first boon he asked was to have his father forgiven.
  4. Intellectual understanding: The fire of knowledge means intellectual understanding.
  5. Let go of the desires: He let go all his desires and did not get attracted to the worldly offers given by the Yama.

Only after that he qualified to receive the knowledge of soul and become a true seeker.

(Disclaimer: The views expressed in this write up are my own).

Tips to relieve heartburn

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  • Avoid foods that trigger your symptoms.
  • Eat small portions and dont overeat; chew food slowly and completely.
  • Avoid smoking, eating quickly, chewing gum, and drinking carbonated beverages as they lead to swallowing excess air.
  • Reduce stress.
  • Get enough rest.
  • Dont lie down within 2 hours of eating.
  • Maintain a healthy body weight.

(Source: Harvard Healthbeat)

The science behind observing Shradhs

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Shradhs are observed every year in Dakshinayana during Chaturmas in the Krishna Paksha of Ashwin month. Many rituals are performed to satisfy the unfulfilled desires of three generations of our ancestors.

According to the Vedas, every individual has three debts to be paid off, firstly, the Devtas (Dev Rin), secondly of Guru and teachers (Rishi Rin) and, thirdly, of Ancestors (Pitra Rin). From the scientific point of view, devtas represent people with Daivik qualities; teachers the ones who have taught us and Pitra, three generations of our ancestors. Rin from scientific point of view would mean unfinished desires or tasks.

The rituals scientifically would mean detaching oneself from the guilt of unfinished tasks of our ancestors by detoxifying our mind.

Debt means desires of our ancestors that had not been fulfilled during their lifetime. The responsibility to fulfil them automatically falls onto the eldest son in the family and they need to be carried out. If not, it is a sign of guilt disorder in the family and may present with loss of wealth, loss of direction and courage and health. The resultant problems faced were called Pitra Dosh in mythology.

The ritual of performing Shradhs originated to remove this guilt and the resultant illnesses. Shradh has many components.

  • Tarpan (offering water to the ancestors while reciting Mantras).
  • Arpan (preparing food what the ancestors used to like on the day of Shradh)
  • Brahmin bhoj (offering Satvik food to Brahmins)
  • Pind Daan (offering black sesame, Kusha Grass, Jwar and boiled or baked rice); observed by some.
  • Observing a spiritual holiday or incubation period (taking a break from the routine worldly desires and going to a distant place like Gaya).
  • Remembrance: Once the unfulfilled desires of the ancestors are over, remembering our ancestors every year on the day of their death anniversary.

Scientifically, Dakshinayana is the period of negative state of mind (nights are longer than days) and starts from 14th July and ends on 13th January. Chaturmas period (first four months) during Dakshinayana has the maximum negativity in the mind. Chaturmas includes the months of Sawan, Bhado, Ashwin and Kartik.

The negative state of mind in Sawan is related to anger and disturbed mind; in Bhado to non-fulfilment of desires and uncontrolled ego and in the month of Ashwin to guilt because of non-fulfilment of desires of others (ancestors), especially during Amavasya.

In the rituals, Tarpan of Jal (water) is offered to ancestors. Jal in mythology means flow of thoughts and offering Jal in mythology equates to confession and getting connected. Tarpan is always done with an aim to purify the mind and wash off the guilt.

Tarpan is always done after the desires of our ancestors have been fulfilled by the person performing the Shradh. This ritual is Arpan. Tarpan and Arpan on the day of Shradh mean getting connected to our consciousness and informing that all the unfinished tasks are over so that we can get rid of the long persisting guilt from our mind. Offering and making food which was liked by our ancestors on that day is just to remember and pay respect to them.

Confession is only possible in a Satwik state of mind, which requires eating of Satwik food for a few days. The ritual of offering Satwik food to Brahmins during the Shradh means making only Satwik food on that day so that everyone in the family is forced to eat Satwik food during Shradhs.

Pind Daan denotes medicinal ways of detaching oneself from the guilt. All the four offerings (black sesame, Kusha grass, Jwar and boiled or roasted rice) in Ayurveda have been described to detoxify the mind and making it Satwik by removing Rajas and Tamas.

If the guilt does not go by repeated Shradhs then one is required to go for a spiritual vacation during Shradh period so that he is away from the worldly desires for a few days before the Shradh and this is what going to Gaya means. This spiritual retreat works like an incubation period to the disturbed mind and gets rid of the disturbed mind and allows the undisturbed state of mind to confess and purify.

The Pitra ceremonies are usually performed either on Amavasya every month (period of most negativity in a month) or on the death anniversary or the Hindu Tithi (day) of the death of the ancestors coinciding with the day during Shradh days. If the date of death is not known then the Shradh is observed on Amavasya.

Some people perform Shradh for full 15 days and others perform it from the first day till the day of their ancestors’ Shradh.

It is said that once a Shradh is successfully performed or Gaya Shradh is performed, there is no need to perform Shradh rituals thereafter. Once the guilt is over, there is no need for further detoxification of the mind. After that the only ritual that needs to be performed is remembrance, which is usually performed on the death anniversary of the deceased ancestor usually by doing some charity on their names.

One is not supposed to do auspicious things during Shradh as during this period, the mind is in a process of detoxification.

Disclaimer: The views expressed in this write up are entirely my own.

Hand, foot and mouth disease: Salient facts

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  • Hand, foot and mouth disease is a viral illness most commonly caused by the Coxsackie virus A6.
  • Enteroviruses 71 (EV71) can also cause hand, foot and mouth disease.
  • Both adults and children can develop this infection. But young children below 5 years old are more susceptible.
  • It is a moderately contagious illness.
  • The incubation period is 5 days.
  • The illness begins with fever, which lasts for 24-48 hours.
  • Fever is followed by appearance of painful sores in mouth. They begin as small red spots that blister and then often become ulcers. Tongue is involved.
  • There are peripherally distributed small tender non itchy rash with blisters on palms of the hands, and soles of feet and buttocks.
  • The sores hurt on touch and swallowing is difficult.
  • There is proximal separation of nail from the nail bed.
  • The virus is present in mucus from nose, saliva, fluid from sores and traces of bowel movements.
  • The virus spreads in the first week of infection.
  • The infection spreads from person to person by direct contact with nasal discharge, saliva or blister fluid or from stool of infected persons.
  • The virus can persist in the stool for weeks.
  • The illness is not transmitted to or from pets or other animals
  • The illness stays for 2-3 days. It is usually mild and self-limited.
  • Enterovirus 71 is associated with brain involvement (meningitis and encephalitis), lungs and the heart.
  • The patient remains infectious after the symptoms have gone.
  • Test is not necessary.
  • There is no specific treatment.
  • Paracetamol tablet can be taken to relieve pain and fever.
  • Aspirin is to be avoided in children.
  • Avoid dehydration.
  • Eat ice cream to numb the pain.
  • Using mouthwashes or sprays that numb the mouth.
  • Regularly wash your hands with soap and water.
  • Avoid exposure to infected person.
  • Maintain touch hygiene to reduce your risk of acquiring the infection.
  • During first week of illness, the child should be kept in isolation.
  • Schools should be closed.
  • There is no vaccine currently available.

Why is Ganesha worshipped in every puja?

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Every Hindu ritual traditionally begins with a prayer to Lord Ganesh. The wedding ceremony too begins with a puja of Lord Ganesha invoking him to bless the couple and to ensure that the ceremony goes off well.

Ganesha, the son of Shiva and Parvati, is the harmonious Aacharan or characteristic disposition of man. Remembered and ritually worshipped before starting a new venture, the entity of Ganesha has in store the facets of a complete man.

Ganesha’s head, that of an elephant, represents wisdom, intelligence and a healthy mind capable of making sound decisions. Think before you speak, implies Ganesha’s head.

The big ears of this elephant deity signify the lending of a patient ear to the echo produced by others’ deeds and speech. It is said that half the dispute is resolved by patiently lending an ear to the words of the other. It also denotes that one must patiently listen to all sides before reaching a decision.

Ganesha’s extremely small mouth characteristically represents the need for a limited dialogue and the vanity of talking too much. Over-expression through words causes unsought-for problems which could have been avoided.

Ganesha’s small eyes highlight the need for a focused outlook in life. Such an outlook not only re-defines and foresees the right goals, but also relieves one from the stress-manifested episodes in life.

The long trunk identifies with the power of discrimination. Ganesha’s long nose has the strength to uproot a tree and the competency of picking up a pin from the ground. Such should be the approach of an individual who should be capable of perceiving the good and bad for himself, and then have the strength to overcome these against all odds.

The tusks and the small teeth of Ganesha tell us to maintain a balance between loss (broken tooth) and gains (whole tooth) in life. Man ought to maintain his mental state so that ups and downs do not deter him from his honest endeavors.

The ample stomach of Ganapati Deva advocates the need for retaining information. Acquiring knowledge, utilizing it and retaining it for years to come, is the crux of ‘big-belly commandment’.

The Char-Bhuja Dhari Ganesha, further represents strength by virtue of his four hands in which the Lord entraps his attachments, desires and greed. Two of the arms of Ganesha, which hold a rope, symbolize control over the attachments. The laddoo or sweet in one shows command over desires and earthly delusions. The mouse sitting near the feet of Ganesha represents greed and gluttony upon which the Almighty rides, exhibiting control over evils.

Ganesha’s physical traits are an assembly of the characteristics most desired in an individual of substance.

(Disclaimer: The views expressed in this write up are my own).

Tips for safe eating

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  • Snack with raw vegetables instead of potato chips.
  • Add fruits in breakfast.
  • Prefer juice instead of a usual coffee, tea or soda.
  • Wash fruits and vegetables with water and scrub with a dish brush when appropriate.
  • Throw away the outer leaves of leafy vegetables, such as lettuce and cabbage.
  • Peel and cook when appropriate, although some nutrients and fiber may be lost when produce is peeled.
  • Avoid fruits and vegetables that look brownish, slimy or dried out. These are signs that the product has been held at an improper temperature.
  • Wash cutting boards with hot water, soap and a scrub brush to remove food particles.
  • Wash hands with warm water and soap for at least 20 seconds before and after handling food, especially fresh whole fruits and vegetables and raw meat, poultry and fish. Clean under fingernails, too.

Definition of Health

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Health is not mere absence of disease; it is a state of physical, mental, social, spiritual, environmental and financial well-being. Allopathy does not define all aspects of health.

During MBBS, medical students are taught more about the physical health. Social and mental health are covered only in few lectures. Community health is a separate subject but never given its due importance. Spiritual health is not defined at all and financial health is hardly covered.

Yet, in day-to-day practice, it is the social, financial, spiritual and community health, which is the most important during patient-doctor communication. It is incorporated in the four basic purposes: dharma, artha, kama and moksha.

Dharma and artha together form the basis of karma which is righteous earning. You are what your deep-rooted desires are. Most of the diseases today can be traced to a particular emotion, positive or negative. Anger and jealously are related with heart attack, fear with blood pressure, greed and possessiveness with heart failure. Unless the mind is healthy, one cannot be free of diseases.

The best description of health comes from Ayurveda. In Sanskrit, health means swasthya, which means establishment in the self. One is established in the self when there is a union of mind, body and soul. Most symbols of health are established around a shaft with two snakes and two wings. The shaft represents the body, two snakes represent the duality of mind and the two wings represent the freedom of soul.

Sushrut Samhita in Chapter 15 shloka 10 defines the ayurvedic person as under:

Samadosha, samagnischa,

Samadhatumalkriyah,

Prasannatmendriyamanah,

Swastha iti abhidhiyate.

From the Ayurvedic point of view, for a person to be healthy, he must have balanced doshas, balanced agni, balanced dhatus, normal functioning of malkriyas and mind, body, spirit and indriyas full of bliss and happiness.

Human body is made up of structures (Kapha) that perform two basic functions: firstly, metabolism (pitta) and movement (vata). Vata, pitta and kapha are called doshas in Ayurveda. Samana dosha means balance of structures, metabolism and movement functions in the body. Agni in Ayurveda is said to be in balance when a person has normal tejas and a good appetite.

Ayurveda describes seven dhatus: rasa, rakta, mamsa, medha, asthi, majja, shukra and they are required to be in balance. They are equivalent to various tissues in the human body.

Ayurveda necessitates proper functioning of natural urges like urination, stool, sweating and breathing and that is what balances in malakriya means.

Ayurveda says for a person to be healthy, he has to be mentally and spiritually healthy which will only happen when his or her indriyas are cheerful, full of bliss and devoid of any negativities. For indriyas to be in balance one has to learn to control over the lust cum desires, greed and ego. This can be done by learning regular pranayama, learning the do’s and don’ts in life, living in a disciplined atmosphere and learn to live in the present.

Regular pranayama shifts one from sympathetic to parasympathetic mode, balances the mind and thoughts and helps in removing negative thoughts from the mind. Living in the present means conscious or meditative living. This involves either learning meditation 20 minutes twice a day or learning subtle mental exercises like mind–body relaxation, yogic shavasana, self–hypnotic exercises, etc.

According to Yoga Sutras of Patanjali, a person who eats thrice a day is a rogi, twice a day is a bhogi and once a day is yogi. The take home message is: to live more, eat less.

Swar yoga defines the importance of respiration and longevity. According to this yoga shastra, everybody has a fixed number of breaths to be taken during the life span.

Lesser the number a person takes in a minute, more is the life. It also forms the basis of pranayama which is nothing but longer and deeper breathing with reduced respiratory rate. To be healthy one can remember to follow the principle of moderation and variety in diet and exercise, regular pranayama and meditation and positive thinking.

Disclaimer: The views expressed in this write up are entirely my own.

Water Hygiene

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Safe water is an essential commodity for prevention of most water- and food-borne diseases, like diarrhea, typhoid and jaundice. These diseases are 100% preventable. All of them can be potentially life-threatening if not prevented, diagnosed or treated in time. Transmission of parasitic infections can also occur with contaminated water. Here are a few tips:

  • Travelers should avoid consuming tap water.
  • Avoid ice made from tap water.
  • Avoid any food rinsed in tap water.
  • Chlorination kills most bacterial and viral pathogens.
  • Chlorination does not kill Giardia cysts.
  • Chlorination does not kill amoeba cysts.
  • Chlorination does not kill Cryptosporidium.
  • Boiled/treated/bottled water is safe.
  • Carbonated drinks, wine and drinks made with boiled water are safe.
  • Freezing does not kill the organisms that cause diarrhea. Ice in drinks is not safe unless it has been made from adequately boiled or filtered water.
  • Alcohol does not sterilize water or ice. Mixed drinks may still be contaminated.
  • Hot tea and coffee are the best alternates to boiled water.
  • Bottled drinks should be requested without ice and should be drunk from the bottle with a straw rather than with a glass.
  • Boiling water for 3 minutes followed by cooling to room temperature will kill bacteria and parasites.
  • Adding two drops of 5% sodium hydrochloride (bleach) to quarter of water (1 liter) will kill most bacteria in 30 minutes.
  • Adding 5 drops of tincture of iodine to a quarter of water (1 liter) will kill bacteria within 30 minutes.

Signs of Spiritual Awakening

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  • More experiences of telepathy
  • More experiences of reverse telepathy
  • More spontaneous fulfillment of desires
  • Increased tendency to let things happen rather than make them happen. Work done with the least effort.
  • Change in the nature, more smiling, laughter and thankful nature.
  • Feelings of being connected with others and nature.
  • Frequent overwhelming episodes of appreciation.
  • Tendency to think and act spontaneously rather than from fears based on past experience.
  • Ability to enjoy each moment.
  • Living in the present.
  • Loss of worry.
  • A loss of interest in conflict.
  • A loss of interest in interpreting the actions of others.
  • A loss of interest in judging others and self.
  • Gaining the ability to love without expecting anything in return.
  • Quality of converting an adversity into opportunity.
  • Dislike for drugs, smoke and excess of alcohol.
  • Happiness in doing random acts of kindness.
  • Looking for good in every one.

Food poisoning with rice dishes

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Staph and Bacillus cereus can cause acute food poisoning within 6 hours of ingestion of food. B. cereus is likely when rice is the culprit.

  • B. cereus is able to persist in food processing environments due to its ability to survive at extreme temperatures as well as its ability to form biofilms and spores.
  • B. cereus has been recovered from a wide range of foods, including rice, dairy products, spices, bean sprouts and other vegetables.
  • Fried rice is an important cause of emetic-type food poisoning associated with B. cereus.
  • The organism is frequently present in uncooked rice, and heat-resistant spores may survive cooking.
  • Cooked rice, subsequently at room temperature, can allow vegetative forms to multiply. The heat-stable toxin that is produced can survive brief heating such as stir frying.
  • Two distinct types of toxin-mediated food poisoning are caused by B. cereus, characterized by either diarrhea or vomiting, depending on which toxin is involved. The diarrheal toxin is produced by vegetative cells in the small intestine after ingestion of either bacilli or spores. The emetic toxin is ingested directly from contaminated food. Both toxins cause disease within 24 hours of ingestion.
  • The emetic syndrome is caused by direct ingestion of the toxin.
  • The number of viable spores and vegetative bacteria that produce diarrheal toxin is reduced by heating, although spores associated with emetic toxin are capable of surviving heat processing.
  • Cereulide is heat stable and resistant to gastric conditions.
  • The ingested toxin itself may therefore cause disease despite sufficient heating to kill B. cereus.
  • The emetic syndrome is characterized by abdominal cramps, nausea and vomiting. Diarrhea also occurs in about one-third of individuals. Symptom onset is usually within one to five hours of ingestion, but it can also occur within half an hour and up to six hours after ingestion of contaminated food.
  • Symptoms usually resolve in 6 to 24 hours.
  • Rice-based dishes, in particular, have been implicated in emetic toxin-mediated disease, usually as a result of cooling fried rice dishes overnight at room temperature followed by reheating the next day.
  • The infective dose of cereulide required to cause symptoms is 8 to 10 micrograms per kilogram of body weight.

Positive Attitudes

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All those out there who feel you are at your wits’ end wondering how things don’t ever work out for you, can now relax and dwell on all those failures that life has taken you through and turn failure into success.

  1. Failure doesn’t mean you are a failure. But it does mean you haven’t succeeded yet.
  2. Failure doesn’t mean you have accomplished nothing. It does mean you have learned something.
  3. Failure doesn’t mean you have been foolish. It does mean you had a lot of faith.
  4. Failure doesn’t mean you’ve been discouraged. It does mean you were willing to try.
  5. Failure doesn’t mean you don’t know what to do. It does mean you have to do it in a different way.
  6. Failure doesn’t mean you are inferior. It does mean you are not perfect.
  7. Failure doesn’t mean you have wasted your life. It does mean you have a reason to start afresh.
  8. Failure doesn’t mean you should give up. It does mean you must try harder.
  9. Failure doesn’t mean you’ll never make it. It does mean it will take a little longer.
  10. Failure doesn’t mean God has abandoned you. It does mean God has a better idea.

Poor hygiene may lead to typhoid fever

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Typhoid fever is caused by a bacterium called Salmonella typhi and is transmitted through the ingestion of food or drink that has been contaminated by the feces or urine of infected people. Flying insects feeding on feces may occasionally transfer the bacteria through poor hygiene habits and public sanitation conditions.

Though the cases occur round the year, more cases are seen during the summer and rainy seasons.

Symptoms usually develop 1-3 weeks after exposure, and may be mild or severe. They include high fever, malaise, headache, constipation or diarrhea and enlarged spleen and liver. A healthy carrier state may follow acute illness.

It can be treated with antibiotics. However, resistance to common antimicrobials is widespread. Healthy carriers should be excluded from handling food.

Sanitation and hygiene are the critical measures that can be taken to prevent typhoid.

Few salient facts about typhoid fever

  • Typhoid does not affect animals and therefore transmission is only from human to human.
  • Typhoid can only spread in environments where human feces or urine are able to come into contact with food or drinking water.
  • Careful food preparation and washing of hands are crucial to preventing typhoid.
  • Typhoid fever, in most cases, is not fatal.
  • Prompt treatment of the disease with antibiotics reduces the case-fatality rate to approximately 1%.
  • When untreated, typhoid fever persists for 3 weeks to a month.
  • Resistance to common antibiotics is now common.
  • Typhoid that is resistant to common antibiotics is known as multidrug-resistant (MDR) typhoid.
  • Ciprofloxacin resistance is an increasing problem, especially in the Indian subcontinent and Southeast Asia.
  • Azithromycin is a new drug for drug-resistant typhoid.
  • Typhoid vaccine taken every 3 years is the best preventive approach.