Do You Really Know about Hepatitis A?


Hepatitis A is a liver disease caused by the hepatitis A virus. The virus is primarily spread when an uninfected (and unvaccinated) person ingests food or water that is contaminated with the faeces of an infected person. The disease is closely associated with unsafe water, inadequate sanitation and poor personal hygiene.

Unlike hepatitis B and C, hepatitis A infection does not cause chronic liver disease and is rarely fatal, but it can cause debilitating symptoms and fulminant hepatitis (acute liver failure), which is associated with high morality. Hepatitis A occurs sporadically and in epidemics worldwide, with a tendency for cyclic recurrences. The hepatitis A virus is one of the most frequent causes of foodborne infection. Epidemic related to contaminated food or water can erupt explosively, such as the epidemic in Shanghai in 1988 that affected about 300,000 people. Hepatitis A viruses persist in the environment and can withstand food-production processes routinely used to inactivate and/or control bacterial pathogens.

The disease can lead to significant economic and social consequences in communities. It can take weeks or months for people recovering from the illness to return to work, school or daily life. The impact on food establishments identified with the virus, and local productivity in general, can be substantial.

Transmission
The hepatitis A virus is transmitted primarily by the faecal-oral route; that is when an uninfected person ingests food or water that has been contaminated with the faeces of an infected person. Waterborne outbreaks, though in frequent, are usually associated with sewage-contaminated or inadequately treated water. The virus can also be transmitted through close physical contact with an infectious person, although casual contact among people does not spread the virus.

Symptoms
The incubation period of hepatitis A is usually 14-28 days. Symptoms of hepatitis A range from mild to severe, and can include fever, malaise, loss of appetite, diarrhea, nausea, abdominal discomfort, dark-coloured urine and jaundice (a yellowing of the skin and whites of the eyes). Not everyone who is infected will have all of the symptoms.

Adults have signs and symptoms of illness more often than children, and the severity of disease and mortality increases in order age groups. Infected children under 6 years of age do not usually experience noticeable symptoms, and only 10% develop jaundice. Among older children and adults, infection usually causes more severe symptoms, with jaundice occurring in more than 70% of cases.

Who is at risk?
Anyone who has not been vaccinated or previously infected can contract hepatitis A. In areas where the virus is widespread (high endemicity), most hepatitis A infections occur during early childhood. Risk factors include:
  •   Poor sanitation
  •   Lake of safe water
  •    Injection drugs
  •    Living in a household with an infected person
  •    Being a sexual partner of someone with acute hepatitis A infection
  •   Travelling to areas of high endemicity without being immunized
Diagnosis
Cases of hepatitis A are not clinically distinguishable from other types of acute viral hepatitis. Specific diagnosis is made by the detection of HAV-specific IgM and IgG antibodies in the blood. Additional tests include reverse trascriptase polymerase chain reaction (RT-PCR) to detect the hepatitis A virus RNA, but may require specialished laboratory facilities.

Treatment
There is no specific treatment for hepatitis A. Recovery from symptoms following infection may be slow and may take several weeks or months. Therapy is aimed at maintaining comfort​​ and edequate nutritional balance, including replacement of fluids that are lost from vomiting and diarrhorea.

Prevention
Improved sanitation, food safety and immunization are the most effective ways to combat hepatitis A.
The spread of hepatitis A can be reduced by:
  •  Adequate supplies of safe drinking water
  •   Proper disposal of sewage within communities
  •   Personal hygiene practices such as regular hand-washing with safe water.
Several hepatitis A vaccines are available internationally. All are similar in terms of how well they protect people from the virus and their side-effects. No vaccine is licensed for children younger than 1 year of age.

Nearly 100% of people develop protective levels of antibodies to the virus within 1 month after a single dose of the vaccine. Even after exposure to the virus, a single dose of the vaccine within 2 weeks of contact with the virus has protective effects. Still, manufacturers recommend two vaccine dose to ensure a longer-term protection of about 5 to 8 years after vaccination.

Millions of people have been immunized worldwide with no serious adverse events. The vaccine can be given as part of regular childhood immunizations programmes and also with other vaccines for travellers.

Immunization efforts
Vaccination against hepatitis A should be part of a comprehensive plan for the prevention and control of viral hepatitis. Planning for large-scale immunization programmes should involve careful economic evaluations and consider alternative or additional prevention methods, such as improved sanitation, and health education for improved hygiene practices.

Whether or not to include the vaccine in routine childhood immunizations depends on the local context. The proportion of susceptible people in the population and the level of exposure to the virus should be considered. Several countries, including Argentina, China, Israel, Turkey, and the United States of America have introduced the vaccine in routine childhood immunizations. While the 2 dose regimen of inactivated hepatitis A vaccine is used in many countries, other countries may consider inclusion of a single-dose inactivated hepatitis A vaccine in their immunization schedules. Some countries also recommend the vaccine for people at people at increased risk of hepatitis A, including:
  • Travellers to countries where the virus is endemic
  • Men who have six with men
  •   People with chronic liver disease (because of their increased risk of serious complications if they acquire hepatitis A infection).
Regarding immunization for outbreak response, recommendations for hepatitis A vaccination should also be site-specific. The feasibility of rapidly implementing a widespread immunization campaign is started early and when high coverage of multiple age groups is achieved. Vaccination efforts should be supplemented by health education to improve sanitation, hygiene practices and food safety.
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How Much Do you Know about Hepatitis B?



Hepatitis B is a viral infection that attacks the liver and can cause both acute and chronic disease. The virus is transmitted through contact with the blood or other body fluids of an infected person. An estimated 240 million people are chronically infected with hepatitis B (defined as hepatitis B surface antigen positive for at least 6 months). More than 780 000 people die every year due to   complications of hepatitis B, including cirrhosis and liver cancer. Hepatitis B is an important occupational hazard for health workers. However, it can be prevented by currently available safe and effective vaccine.
                 
Hepatitis B is a potentially life-threating liver infection caused by the hepatitis B. It is a major global health problem. It can cause chronic infection and puts people at high risk of death from cirrhosis and liver cancer.

A vaccine against hepatitis B has been available since 1982. The vaccine is 95% effective in preventing infection and the development of chronic disease and liver cancer due to hepatitis B.

Transmission
The hepatitis B virus can survive outside the body at least 7 days. During this time, the virus can still cause infection if it enters the body of a person of the hepatitis B virus is 75 days on average, but can vary from 30 to 180 days. The virus may be detected within 30 to 60 days after infection and can persist and develop into chronic hepatitis B.

In highly endemic areas, hepatitis B is most commonly spread from mother to child at birth (perinatal transmission), or through horizontal transmission (exposure to infection blood), especially from an infected child to an uninfected child during the first 5 years of life. The development of chronic infection is very common in infants infected from their mothers or before the age of 5 years. Hepatitis B is also spread by percutaneous or mucosal exposure to infected blood and various body fluids, as well as through saliva, menstrual, vaginal, and seminal fluids. Sexual transmission of hepatitis B may occur, particularly in unvaccinated men who have sex with men and heterosexual persons with multiple partners or contacts with sex workers. Infection in adulthood leads to chronic hepatitis B in less than 5% of cases. Transmission of the virus may also occur through the reuse of needles and syringes either in health-care settings among persons who inject drugs. In addition, infection can occur during medical, surgical and dental procedures, tattooing, or through the use of razors and similar objects that are contaminated with infected blood.

Symptoms
Most people do not experience any symptoms during the acute infection phase. However, some people have acute illness with symptoms that last several weeks, including yellowing the skin and eyes (jaundice), dark urine, extreme fatigue, nausea, vomiting and abdominal pain. A small subset of persons with acute hepatitis can develop acute liver failure which can lead to death.

In some people, the hepatitis B virus can also cause a chronic liver infection that can later develop into cirrhosis of the liver or liver cancer. More than 90% of healthy adults who are infected with hepatitis B virus will recover naturally from the virus within the first year.

Who is at high risk for chronic disease?
The likelihood that infection with the virus becomes chronic depends upon the age at which a person becomes infected. Children less than 6 years of age who become infected with the hepatitis B virus are the most likely to develop chronic infections.
In infants and children:
  •   80-90% of infants infected during the first year of life develop chronic infection
  •         30-50% of children infected before the age of 6 years develop chronic infection
In adults:
  • <5% of otherwise healthy persons who are infected as adults will develop chronic infection
  •    20-30% of adults who are chronically infected will develop cirrhosis and/or liver cancer.

Diagnosis
It is not possible, on clinical grounds, to differentiate hepatitis B from hepatitis caused by other viral agents and, hence, laboratory confirmation of the diagnosis is essential. A number of blood tests are available to diagnose and monitor people with hepatitis B. they can be used to distinguish acute and chronic infections. Laboratory diagnosis of hepatitis B infection focuses on the detection of hepatitis B surface antigen HBsAg. WHO recommends that all blood donations are tested for hepatitis B to ensure blood safety and avoid accidental transmission to people who receive blood products.

Acute HBV infection is characterized by the presence of HBsAg and immunoglobulin M(IgM) antibody to the core antigen, HBcAg. During the initial phase of infection, patients are also seropositive for hepatitis B antigen
(HBsAg). HBsAg is usually a marker of high levels of replication of the virus. The presence of HBsAg indicates that the blood and body fluids of the infected individual are highly contagious.

Chronic infection is characterized by the persistence of HBsAg for at least 6 months (with or without concurrent HBsAg). Persistence of HBsAg is the principal marker of risk for developing chronic liver disease and liver cancer (hepatocellular carcinoma) later in life.

Treatment
There is no specific treatment for acute hepatitis B. Therefore, care is aimed at maintaining comfort and adequate nutritional balance, including replacement of fluids lost from vomiting and diarrhea. Chronic hepatitis B infection can be treated with drugs, including oral antiviral agents. Treatment can slow the progression of cirrhosis, reduce incidence of liver cancer and improve long term survival.

WHO recommends the use of oral treatments- tenofovir or entecavir, because these are the most potent drugs to suppress hepatitis B virus. They rarely lead to drug resistance as compared with other drugs, are simple to take (1 pill a day), and have few side effects so require only limited monitoring.

However, in most people, the treatment does not cure hepatitis B infection, but only suppresses the replication of the virus. Therefore, most people who start hepatitis B treatment must continue it for life. Treatment using interferon injections may be considered in some people in certain high-income settings, but its use is less feasible in low-resource settings due to high cost and significant adverse effects requiring careful monitoring.

There is still limited access to diagnosis and treatment of hepatitis B in many resource-constrained settings, and many people are diagnosed only when they already have advanced liver disease. Liver cancer progressive rapidly, and since treatment options are limited, the outcome is in general poor. In low-income settings, most people with liver cancer die within months of diagnosis. In high-income countries, surgery and chemotherapy can prolong life for up to a few years. In high-income countries, liver transplantation is sometimes used in people with cirrhosis, with varying success.

Prevention
The hepatitis B vaccine is the mainstay of hepatitis B prevention. WHO recommends that all infants receive the hepatitis B vaccine as soon as possible after birth, preferably within 24 hours. The birth dose should be followed by 2 or 3 doses to complete the primary series. In most cases, one of the following two options is considered appropriate:
  • A 3-dose schedule of hepatitis B vaccine, with the first dose (monovalent) being given at birth and same and third (monovalent or combined vaccine) given at the same time as the first and third doses of diphtheria, pertussis (whooping cough), and tetanus -  (DTP) vaccine
  •   4 dose, where series induces protective antibody levels in more than 95% of infants, children and young adults. Protection lasts at least 20 years and is probably lifelong. Thus, WHO does not recommend booster vaccination for persons who have completed the 3 dose vaccination schedule.
All children and adolescents younger than 18 year-old and not previously vaccinated should receive the vaccine if they live in countries where there is low or intermediate endemicity. In those settings it is possible that more people in high-risk groups may acquire the infection and they should also be vaccinated. They include:
  •  People who frequently require blood or blood products, dialysis patients, recipients of solid organ transplantation
  •     People interned in prisons
  •    Person who inject drugs
  •   Household and sexual contacts of people with chronic HBV injection
  •   People with multiple sexual partners
  •   Health-care workers and others who may be exposed to blood and blood products through their work
  •   Travellers who have not completed their hepatitis B vaccination series, who should be offered the vaccine before leaving for endemic areas.
The vaccine has an excellent record of safety and effectiveness. Since 1982, over 1 billion doses of hepatitis B vaccine have been used worldwide. In many countries where 8-15% of children used to become chronically infected with the hepatitis B virus, vaccination has reduced the rate of chronic infection to less than 1% among immunized children.
As of 2013, 183 Member States vaccinate infants against hepatitis B as part of their vaccination schedules and 81% of children received the hepatitis B vaccine. This is a major increase compared with 31 countries in 1992, the year that the World Health Assembly passed a resolution to recommend global vaccination against hepatitis B. furthermore, as of 2013, 93 Member States have introduced the hepatitis B birth dose vaccine.
In addition, implementing of blood safety strategies, including quality-assured screening of all donated blood and blood components used for transfusion, can prevent transmission of HBV. Safe injection practices, eliminating unnecessary and unsafe injections, can be effective strategies to protect against HBV transmission. Furthermore, safer sex practices, including minimizing the number of partners and using barrier protective measures (condoms), also protect against transmission.
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Skillful Painter: Amazing Painting

Painting is kinds of art which make people feel happy or sad.The spray paint art is so popular in many counties. These videos below show about how they paint the painting by using the sprayers to paint. It looks so amazing and he paints it so quickly. Find out more about the art painting, here it is:
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Useful Benefits of Drinking Tea

Scientists, doctors, mystics and even our grandparents all talk about the health benefits that come from drinking tea. Many of us have the general idea that tea is good for us but don’t really know what it specifically does. It is also good to know that different types of tea have effects on the body. Here are some health benefits of tea:




Tea is an anti-cancer plant
The studies are now pretty clear – if you drink a lot of tea you are less likely to get cancer. And not just a little bit less likely, a lot! If you drink about four cups of tea a day you are up to 60% less likely to get cancer thanks to the antioxidants in tea leaves. That is an amazing statistic.

The studies have really only been done with Green Tea but others are currently underway. White Tea is supposed to be even more effective from a traditional point of view and there is some scientific evidence to support this fact. I personally would love to see more studies done on Oolong Tea as it has the added benefits of mold growing on it.

Tea boosts your brain
One of the notable effects of tea is that it helps you concentrate and focus. This is important for all of us who are sitting on a computer trying to stay on track with some really boring data analysis.

This effect is said to be due to the amino acid L-theanine which gets absorbed in your gut and travels in the blood to your brain. This results in a more awake you! The thing that is really cool about this is that tea doesn’t make you get all hyper like coffee does. It is a calming drink that wakes you up without over stimulating.

Tea helps you fight off illness
Tea is supposed to be a very strong immune booster. Those people who drink tea on a regular basis are supposed to be more immune to the cold or flu that is going around at work as well as some other minor health problems such as infections. Moreover, tea is very helpful for fighting against different diseases like heart disease, cancer etc. what  is more, tea has various antioxidants that can cleanse the human body from unwanted substances.

Tea beats stress
If you are reading this post at work then chances are you are pretty stressed. The good news is that a cup of tea helps you fight the physical signs of stress by reducing the stress hormone in your body.

Tea can help you lose weight
Many studies have confirmed what the Chinese doctors have been telling us for centuries – tea boosts your metabolism and helps you lose weight. Drinking a few cups of green tea at work (without the sugar) can have a really good effect on your waistline.
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How bad is it for drinking tea?


Now that we have looked at all the nice things tea can do it is a good idea to take a look at whether tea will cause your body any harm. Before making any decision about your health it is important to weight up the pros and cons of the argument and then makes a decision based upon good information. To rant on about the magical qualities of tea without talking about the potential drawbacks would be irresponsible.
Sleep problems
Many people are very sensitive to the effects of caffeine. If I have a tea or a coffee within four hours of my bed time I will have a lot of trouble getting sleep.
If you are having sleep problems already it might be a good idea to take a look at how many teas you are drinking. Many people do not realize that tea is quite high in caffeine and too much tea can affect how well you sleep. However, your sleeplessness might be caused by other things. Take a look at this post about stressed sleep.
Kidney damage
Some scientific studies have shown that the oxalates in tea can cause some kidney damage. However, this has only been shown in people who drink a lot of tea – a lot more than most of us drink.
Although there other drawbacks associated with tea none of them have been definitively proven by science. The main message is that excess is not a good idea. If you are drinking more than about four cups of tea a day you are more likely to have some negative effects.
Gastric ulcers
The most important disadvantage of drinking tea is that too much of the beverage brings the chance of gastric ulcers. Person should remember tea that tea has lesser amount of caffeine than coffee.
Tannic acid
If the person drink tea is the maximum quantity then he may experience the problem of iron deficiency and anemia. It is advisable that person should consume tea almost an hour after he has eaten meal.

Extra
Here are some other tips which reduce the capacity of tea:
Add milk
Scientists have found that adding milk to your tea actually detracts from the health benefits. The article in New Scientist is here.
Origin of tea
One of the best things you can do if you are serious about your health is research where your tea comes from. I learned this trick in India and I think it makes a lot of sense. Pollution in the air and soil has a massive effect on how healthy your tea is places like China and India have a lot of air pollution. Try to source your tea from remote provinces in China and India – places higher in altitude. As a general rule Chinese Green Tea’s grow in higher areas.
 Add sugar
Sugar is like a leech. It has so many negative effects on the body and you should avoid it at all costs. If you can cut out or reduce the amount of sugar that you put in your tea you will be doing your body a big favor.

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Mokeys Riding on the Dogs

Everything come out to the real world by imagination of human.In this case, they have trained the monkeys along with dogs for a best performance that we have ever seen before. Don't hesitate to watch video below :

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12 Sings of Falling in Love

Falling in love is the best feeling and an individual experiences. Your body and mind, both are influenced to your every things, which you have never imagined. So how do you know whether you are falling in love with someone or not? Here are 12 signs that will tell you have fallen into the magical world of love!

Like Singing love Songs
You feel like all love songs were written for you and every time you hear one, you can completely relate to the lyrics! It is true when they say, that love makes you understand the depth of songs.
Someone always on your mind
When you wake up you always thinking about someone; you sleep thinking about someone. Your mind is just occupied with your lover’s thoughts no matter where you are sitting or what you are doing.
Smiling always come out
You will definitely catch yourself smiling when you are alone! When you notice yourself having a smile in your walk and laugh in your talk, you ought to know it the magic of love.
You over the limit of comfort zone
You may not like doing one thing, but your lover like it so you start enjoying it. Example, you may not enjoying cooking, yet you cook a meal for him/her. All this change is because you want to be the one with him/her.
Appearance become the problem
Every time you go to meet your new found love, you are dressed to kill! You put on your best attire, wear make-up and do your hair – all to impress him/her.
Lover’s emotion means your emotion
The feeling of that person become yours. In fact, a smile of that person’s face means a smile on your; while sadness for him/her, means sadness for you too. Basically, you start sharing his happiness and joy with him/her in good times as well as bad one.

Always Concern
You always wonder about him/her. What is that person doing right now? How that person reached home? Will he/she be safe on the way? Is that person happy with the new friends? You are just overly concerned about the person’s feeling and security.

The word “ us” come out
Your vocabulary has added a new word and your conversations will always include words like us and we. You are in love when you always start referring the two of you as a couple.

You go blind
Love is blind! Yes, you will overlook all the negatives and all the bad! No matter who criticizes his behavior, you think your love is the best person in the whole world!

Saving things
You start saving all things that you have from him/her. Example, the present from him/her, the letter – you have all these saved to be the memories you have shared and celebrate your new love.

You are always in a good mood
No matter what is happening around you, you are not affected by it. You are living in a simply because love has swept you off your feet.

Plan for surprising
You planned a surprise the thing for him/her that you never did before. You may make a surprising birthday for him/her. However, you are busy; for this person you will cross cities and states just to pay a surprise visit see that excited smile. Not only that, you will find yourself looking out for unique gifts to give him/her to show your affection.

Yet, if you found out these sings in your daily life, you should know that it is called love. It is exciting, addictive, weird and happy.
Let’s enjoy this feeling…  “Enjoy building your own love story”
See you again next
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Diabetes

Diabetes is a long-term condition that causes high blood sugar levels. In 2013 it was estimated that over 382 million people throughout the world had diabetes (willams textbook of endocrinology). There are three types of diabetes: type 1 diabetes, type 2 diabetes and gestational diabetes.

There are many points about diabetes that we should know:

Types of diabetes
Type 1 diabetes
      Patients with type 1 diabetes will take insulin injections for the rest of their life because their body does not produce insulin. They must also ensure proper blood-glucose levels by carrying out regular blood tests and following a special diet. Some people may refer to this type as insulin dependent diabetes, juvenile diabetes, or early-onset diabetes. They usually develop type 1 diabetes before their 40th year, often in early adulthood or teenage years. There is about 10% of all diabetes cases are type 1.
Type 2 diabetes
      The body does not produce enough insulin for proper function, or the cells in the body do not react to insulin (insulin resistance). It is typically a progressive disease – it gradually gets worse and the patient will probably end up have to take insulin, usually in tablet form. The kind of people who have high risk of type 2 diabetes are overweight and obese people, older people and low level testosterone men.
Gestational diabetes
      This type affects females during pregnancy. Because they have very high levels of glucose in their blood, women’s bodies are unable to produce enough insulin to transport all of the glucose into their cells. The majority of gestational diabetes can control their diabetes with exercise and diet. Some of them need to take some kind of blood-glucose-controlling medications. Undiagnosed or uncontrolled gestational diabetes can raise the risk of complications during childbirth. The baby may be bigger than he/she should be. Scientist from the National Institutes of Health and Harvard University said that ‘women who have gestational diabetes because they have high of animal fat and cholesterol’.

Symptoms of diabetes

Patients with high blood sugar will typically experience polyuria (frequent urination). They will become increasingly thirsty (polydipsia) and hungry (polyphagia).
The blood glucose levels where higher than normal, but not high enough to merit a diabetes diagnosis as well as the cells in the body are becoming resistant to insulin. This is called prediabetes.  This stag may damage to the circulatory system and the hearth may already have occurred.
Diabetes is a metabolism disorder. Metabolism refers to the way our bodies use digested food for energy and growth. Most of what we eat is broken down into glucose. Glucose is a form of sugar in the blood- it is the principal source of fuel for our bodies.

Determination of diabetes
Doctors can determine whether  a patient has a normal metabolism, prediabetes or diabetes in one of the three different ways – there are three possible tests:
The A1C test
-         at least 6.5%means diabetes
-         between 5.7%and 5.99%means prediabetes
-         less than 5.7% means normal
The FPG (fasting plasma glucose) test
-         at least 126mg/dl means diabetes
-         between 100mg/dl and 125.99mg/dl means prediabetes
-         less than 100mg/dl means normal
An abnormal reading following the FPG means the patient has impaired fasting glucose (IFG).
The OGTT (oral glucose tolerance test)
-         at least 200mg/dl means diabetes
-         between 140 and 199.9mg/dl means prediabetes
-         less than 140mg/dl means normal
An abnormal reading following the OGTT means the patient has impaired glucose tolerance (IGT)

Controlling diabetes
        All types of diabetes are treatable. Diabetes type 1 lasts a lifetime, there is no known cure. Type 2 usually lasts a lifetime; however, some people have managed to get rid of their symptoms without medication, through a combination of exercise, diet and body weight control.
       Patients with type 1 are treated with regular insulin injections, as well as a special diet and exercise.
      Patients with type 2 diabetes are usually treated with tablets, exercise and a special diet, but sometimes insulin injections are also required.

The causes of diabetes
A list of possible complications that can be caused by badly controlled diabetes :
Eye complications : glaucoma, cataracts, diabetic retinopathy, and some others
Foot complications : neuropathy, ulcers, and sometimes gangrene which may require that the foot be amputated
Skin complications: people with diabetes are more susceptible to skin infections and skin disorders
Heart problem: such as ischemic heart disease, when the blood supply to the heart muscle is diminished
Hypertension: common in people with diabetes, which can raise the risk of kidney disease, eye problems, heart attack and stoke
Mental health: uncontrolled diabetes raises the risk of suffering from depression, anxiety and some other mental disorders
Hearing loss: diabetes patients have a higher risk of developing hearing problems
Gum disease: there is a much higher prevalence of gum disease among diabetes patients
Gastroparesis: the muscles of the stomach stop working properly
Ketoacidosis: a combination of ketosis and acidosis, accumulation of ketone bodies and acidity in the blood
Neuropathy: diabetic neuropathy is a type of nerve damage which can lead to several different problems
HHNS (Hyperosmolar Hyperglycemic Nonketotic Syndrome): blood glucose levels shoot up too high, and there are no ketones present in the blood or urine. It is an emergency condition
Nephropathy: uncontrolled  blood  pressure can lead to kidney disease
PAD (peripheral arterial disease): symptoms may include pain in the leg, tingling and sometimes problems walking properly
Stroke: if blood pressure, cholesterol levels, and blood glucose levels are not controlled, the risk of stroke increases significantly
Erectile dysfunction: male impotence
Infections: people with badly controlled diabetes are much more susceptible to infections
Healing of wounds: cuts and lesions take much longer to heal

Some facts and myths (false idea) about diabetes
Many presumed "facts" are thrown about in the paper press, magazines and on the internet regarding diabetes; some of them are, in fact, myths. It is important that people with diabetes, pre-diabetes, their loved ones, employers and schools have an accurate picture of the disease. Below are some diabetes myths:
People with diabetes should not exercise - NOT TRUE!! Exercise is important for people with diabetes, as it is for everybody else. Exercise helps manage body weight, improves cardiovascular health, improves mood, helps blood sugar control, and relieves stress. Patients should discuss exercise with their doctor first.
Fat people always develop type 2 diabetes eventually - this is not true. Being overweight or obese raises the risk of becoming diabetic, they are risk factors, but do not mean that an obese person will definitely become diabetic. Many people with type 2 diabetes were never overweight. The majority of overweight people do not develop type 2 diabetes.
Diabetes is a nuisance, but not serious - two thirds of diabetes patients die prematurely from stroke or heart disease. The life expectancy of a person with diabetes is from five to ten years shorter than other people's. Diabetes is a serious disease.
Children can outgrow diabetes - this is not true. Nearly all children with diabetes have type 1; insulin-producing beta cells in the pancreas have been destroyed. These never come back. Children with type 1 diabetes will need to take insulin for the rest of their lives, unless a cure is found one day.
Don't eat too much sugar, you will become diabetic - this is not true. A person with diabetes type 1 developed the disease because their immune system destroyed the insulin-producing beta cells. A diet high in calories, which can make people overweight/obese, raises the risk of developing type 2 diabetes, especially if there is a history of this disease in the family.
I know when my blood sugar levels are high or low - very high or low blood sugar levels may cause some symptoms, such as weakness, fatigue and extreme thirst. However, levels need to be fluctuating a lot for symptoms to be felt. The only way to be sure about your blood sugar levels is to test them regularly. Researchers from the University of Copenhagen, Denmark showed that even very slight rises in blood-glucose levels significantly raise the risk of ischemic heart disease. (Link to article)
Diabetes diets are different from other people's - the diet doctors and specialized nutritionists recommend for diabetes patients are healthy ones; healthy for everybody, including people without the disease. Meals should contain plenty of vegetables, fruit, whole grains, and they should be low in salt and sugar, and saturated or trans fat. Experts say that there is no need to buy special diabetic foods because they offer no special benefit, compared to the healthy things we can buy in most shops.
High blood sugar levels are fine for some, while for others they are a sign of diabetes - high blood-sugar levels are never normal for anybody. Some illnesses, mental stress and steroids can cause temporary hikes in blood sugar levels in people without diabetes. Anybody with higher-than-normal blood sugar levels or sugar in their urine should be checked for diabetes by a health care professional.
Diabetics cannot eat bread, potatoes or pasta - people with diabetes can eat starchy foods. However, they must keep an eye on the size of the portions. Whole grain starchy foods are better, as is the case for people without diabetes.
One person can transmit diabetes to another person - NOT TRUE. Just like a broken leg is not infectious or contagious. A parent 
  May pass on, through their genes to their offspring, a higher susceptibility to developing the disease.
Only older people develop type 2 diabetes - things are changing. A growing number of children and teenagers are developing type 2 diabetes. Experts say that this is linked to the explosion in childhood obesity rates, poor diet, and physical inactivity.
I have to go on insulin, this must mean my diabetes is severe - people take insulin when diet alone or diet with oral or non-insulin injectable diabetes drugs do not provide good-enough diabetes control, that's all. Insulin helps diabetes control. It does not usually have anything to do with the severity of the disease.
If you have diabetes you cannot eat chocolates or sweets - people with diabetes can eat chocolates and sweets if they combine them with exercise or eat them as part of a healthy meal.
Diabetes patients are more susceptible to colds and illnesses in general - a person with diabetes with good diabetes control is no more likely to become ill with a cold or something else than other people. However, when a diabetic catches a cold, their diabetes becomes harder to control, so they have a higher risk of complications.


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Effective Injection : Giving an Intramuscular Injection

Determine the injection site
An intramuscular injection (IM) delivers medication directly into a muscle. Choose an injection site that has easy access to muscle tissue.

There are four primary sites recommended for administer IM injections. Those include the thigh, the hip, the buttocks, and the upper arm. Alternate between injection sites to prevent bruising soreness, scarring, and skin changes.
Give the injection into the thigh
The vastus lateralis is the name of three sections. The middle section is the target for the IM injection. This is a good site if you are giving yourself an IM injection since you can easily see and reach the target area.
Use the ventrogluteal muscle
This muscle is located in the hip. Use landmarks on the body to find the location where you want to inject the medication.

Find the proper location by having the person lie on his or her side. Place the heel of your hand on the upper and outer part of the thigh where it joins the buttocks. Point your fingers toward the person’s head and point your thumb towards the groin.

You should feel a bone along the tips of your ring finger and little finger.
From a V shape by moving your pointer finger away from the other fingers. The injection is giving in the middle part of the V shape.
Given the injection into the buttocks
The dorsogluteal muscle is the area where you want to inject the medication. With practice the target area becomes easier to locate, but begin by using physical landmarks and divide the area into quadrants to be sure you have the correct area.

Draw an imaginary line, or actual line using an alcohol wipe if available from the top of the crack to the side of the body. Locate the midpoint of that line, and move up three inches. Draw another line that crossed the first one forming a cross.

Locate a curved bone in the upper outer square or quadrant. The injection should be given in the upper outer square below the curved bone.
Administer the injection in the upper arm
The deltoid muscle is located in the upper arm and is a good site for IM injections if there is adequate muscle tissue. Use an alternate site if the person is thin or has little muscle in that area.

Find the acromion process or the bone that crosses the upper arm. Draw an imaginary upside down triangle with the bone as the base and the point of the triangle is the level of the armpit.

Give the injection in the middle of the triangle one to two inches below the acromion process.
Clean the skin on and around the site with an alcohol wipe
Allow the alcohol to dry before administering the injection. Do not touch the cleaned area with your fingers or any other material before giving the injection. Hold the syringe firmly with your dominant hand and remove the needle cover with your other hand. Put pressure on the skin where you are giving the injection. Push down gently and pull the skin so it is tight.
Insert the needle
Use your wrist to inject the needle through the skin at a 90 degree angle. You will need to force the needle deep enough to be sure you deliver the medication into muscle tissue. Selection the correct needle length helps to guide you in the injection process.

Aspirate by pulling the plunger back slightly. Look for blood that is pulled back into the syringe as you pull back on the plunger. If there is blood then carefully remove the needle and find a different to stop to administer the injection. If no blood is seen then continue with giving the injection.
Carefully inject the medicine into the patient
Push the plunger down until all of the fluid has been released. Do not push too hard on the plunger as this force the medication into the site too fast. Push the plunger in a steady but slow manner to reduce pain. Remove the needle in the same angle in which it was injected.

Cover the injection site with a small gauze pad or a cotton ball and a band-aid and check on it regularly. Make sure it looks clean and the injection site is not continuing to bleed.


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Effective Injection IV : Post-Injection Safety

Watch for an allergic reaction
If signs or symptoms of an allergic reaction develop, seek medical attention as soon as possible.

Signs of an allergic reaction include a rash or itching, shortness of breath, difficulty swallowing, feeling like your throat or airway is closing, and swelling of the mouth, lips, or face.
Seek medical attention if you develop an injection
Even the best injection technique can sometimes allow entry of contaminants.

Contact your doctor as soon as possible if you develop a fever, flu-like symptoms, headache, sore throat, joint and muscle aches, and gastrointestinal problems. Other symptoms that warrant prompt medical attention include chest tightness, nasal congestion or stuffiness, a widespread rash, and mental changes like confusion or disorientation.
Monitor the injection site
Watch for changes in skin tissue at the point of injection and the area immediately surrounding it.

Injection site reactions are more common with some drugs than others. Read the product literature before drug administration to know what to look for. Common reactions that occur at the site of an injection include redness in the area, swelling, itching, bruising, and sometimes a raised lump or hardened area. Alternating injection sites can help to minimize damage to the skin and surrounding tissue when frequent injections are needed.

Persistent problems with injection site reactions warrant medical evaluation.
Dispose of used items safely
Sharps containers are a safe way to dispose of used lancets, syringes, and needles. Sharps containers can be purchased at your local pharmacy and are available online.

Never put lancets, syringes, or needles in the regular trash. Review your state’s guidelines. Your pharmacist can help you to find a program that meets your needs. Many states have clear guidelines and suggestions on developing a safe system for disposing of biohazardous waste created from giving injections at home. Sharps, including used needles, lancets and syringes are biohazardous waste since they are contaminated with skin and blood from direct contact with you or the person receiving the injections.

Consider an arrangement with a company that provides milkback kits. Some companies provide a service that supplies you with sharps containers you need and make arrangements that allow you to safely mail the containers to them when they are full. The company takes responsibility for proper destruction of biohazardous waste.

Ask your pharmacy about safe ways to discard any vials that contain unused medications. Often, any opened vials of medication can be placed into the sharps container.


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Effective Injection I : Preparing an Injection

Safe injection practices protect the patient, the person giving the injection, as well as the environment. Take steps to learn how to administer an injection so you can start giving yourself injections, or give injections to a close friend or family member.
Contents:
1.     Preparing to give an injection
2.     Giving a subcutaneous injection
3.     Giving an intramuscular injection
4.     Paying an attention to post-injection safety

Method 1: Preparing to Give an Injection

Determine what type of injection you are giving
Read the detailed instructions that come with the medication, and carefully review any directions given to you by your doctor, nurse, or pharmacist. If you have any questions or doubts about how and when to administer the injection, talk to your doctor, nurse, or pharmacist. Ask questions if you are not sure about the correct syringe, needle length, and needle gauge before proceeding.

Some medications come ready-to-use, while others require you fill the needle with medication from a vial. Be very clear on the supplies you need for the injection. Some people receive more than one type of injection at home. It is easy to confuse the syringes and needles needed for one injection with those intended for use with another medication injection.
Be familiar with the product packing
Not all injectable medication packaging is the same. Some medications may need reconstitution before administration, many come packaged with everything you need including syringes and needles. Be familiar with the product literature that comes with medication and any preparatory steps specific to that medication.

The product literature will give you clear step-by-step instructions on anything you need to do in order to prepare the medication for administration. The literature will also tell you the recommended syringe size, needle size, needle gauge, if those are not included in the packaging.

Give a medication packaged in a single dose vial. Common manufacturer packaging for many injectable medications is done by putting the medication into a vial called a single dose vial.

The label on the medication vial will say either “single dose vial” or will contain the abbreviation, SDV. This means each vial after you have prepared the dose you need to give. The remainder of the medication in the vial is to be discarded and not saved for another dose.
Prepare a dose from a multi dose vial
Other medications are packaged in a multi-dose-vial, which dose allow for more than one dose to be withdrawn from the vial.

The label on the medication will say “multi-dose-vial” or contain the abbreviation, MDV. If the medication you are using is packaged in a multi-dose-vial, use a permanent marker to write the date it was first opened on the container.

Store the medication in the refrigerator between doses. Do not freeze the medication.

Small amounts of preservatives may be used in the manufacturing process for medications contained in the multi-dose-vial. This helps to minimize the growth of any contaminants, but only protects the purity of the medication for up to 30 days after the vial is opened. The vial should be discarded 30 days after the first date of opening has passed, unless your doctor advises you otherwise.
Gather your supplies
You will need the medication package or vial, the syringe that comes with the product if available, a purchased syringe-needle unit, or separate syringes and needles that are put together at the time of administration. Other items you need include alcohol pads, a small gauze pad or cotton ball, a band-aid, and a sharps container

Remove the outer seal from the medication vial then wipe the rubber top of the with an alcohol pad. Always let the area air dry after wiping with an alcohol pad. Blowing on the vial or wiped skin can cause contamination.

Use the gauze pad or cotton ball to apply pressure on the injection site to reduce bleeding. Cover this with a band-aid.
The sharps container is used as an important safety measure to protect the patient, caregiver, and community from biohazardous materials. The container is a thick, plastic, bin designed to hold used sharps. Sharps are lancets, syringes, and needles. When the sharps container is full, arrangements are made to transfer it to a place that destroys biohazard equipment.
Examine the medication
Be sure you have the right medicine in the right strength, and the expiration date has not passed. Be sure the medication vial or package has been stored according to the manufacturer’s guidelines. Some products are stable when kept at room temperature before use and others may need refrigeration

Check the packing for visible damage such as cracks or dents in the vial that holds the medication. Look at the area around the top of the vial. Check for cracks and dents in the seal around the top of the medication container. Dents can mean that the sterility of the medication container. Dents can mean that the sterility of the packaging may no longer be reliable. Look at the liquid inside the container. Check for particulate matter which is anything unusual or floating inside the liquid inside the container. Most injectable medications are clear.

Some insulins appear cloudy. If you notice anything other than clear liquid inside the container, other than some insulins products, then discard it.
Wash your hands
Thoroughly clean your hands using soap water. Include washing your nail area, between your fingers and your wrist area. This helps prevent contamination and reduce the risk of infection.
Inspect the syringe and needle
Be sure the syringe and needle are in unopened, sterile packaging that shows no evidence of damage or deterioration. Upon opening, check the syringe for cracks in the barrel or discoloration of any part of the syringe. This includes the rubber top on the plunger. Any damage or deterioration indicates the syringe should not be used.

Examine the needle for any evidence of damage. Be sure the needle has not been bent or broken. Do not use any product that appears damaged including damage to the packaging that might indicate the needle is no longer considered sterile.

Some packaged syringes and needles have a visible expiration date, but not all manufacturers provide this on packaging. If you are concerned that a product is too old to use, contact the manufacture. Have any lot numbers available when you all.

Discard damaged or deteriorated syringes, or those that have expired, by putting them in a sharps container.
Verify that you have the correct size and type of syringe
Be sure to use a syringe designed for the injection you are giving. Avoid interchanging different types of syringes as this can result in serious errors in dosing. Use only the type of syringe recommended for the medication you are giving.

Select a syringe that holds a little more than the amount you need to administer. Following the manufacturer’s recommendations regarding the needle length and gauge. The needle gauge is the number that describes the diameter of the needle. Larger numbers mean skinnier needles. Some medications are thicker and need a smaller gauge, or larger diameter needle.
Most syringes and needles are currently manufactured as a single unit for safety reasons. When you select your syringe size you also selecting your needle length and gauge. Be sure you have the proper equipment to administer the injection. This information is detailed in the product literature, or is available by asking your pharmacist, doctor, or nurse. Separate syringes needles are still available. If this is what you have, then assemble the syringe and needle. Make sure that the syringe is the proper size and the needle is sterile, unused, and the correct length and gauge for the type of injection you’re performing intramuscular and subcutaneous injections use different needles.
Fill the syringe
Follow the packaging instructions if available or proceed with filling the syringe from the medication vial.

Sterilize the top of the vial with alcohol and allow it to air dry for several minutes.

Prepare to fill your syringe. Know exactly how much liquid medication you need to withdraw and administer for your dose. Your syringes should contain exactly the amount of the prescribed dose. This information is available on the prescription label or the instructions provided by the doctor or pharmacy.

To fill the syringe, pull the plunger back to fill it with air equal to the exact amount of fluid you will need. Holding the vial upside down insert the needle into the rubber seal, and push the plunger back to fill it with air equal to the exact amount of fluid you will need. Holding the vial upside down, insert the needle into the rubber seal, and push the plunger to inject the air from the syringe into the vial.

Pull the plunger out to withdraw the fluid to the exact amount needed for administration.
Sometimes air bubbles are visible in the syringe. Tap the syringe gently while the needle is still in the medication vial. This moves the air to the top of syringe.

Push the air back into the vial then vial then withdraw more medication if needed to be sure you have the exact amount you need to administer.
Get the patient comfortable
Consider icing the area before administering the injection to reduce pain, particularly if the patient is a child. Let him or her sit in a comfortable position with the area exposed.

Be sure you can comfortably reach the area of administration. Have the person remain as still and relaxed as possible. If you wipe the area with alcohol, wait several minutes for the area to air dry before inserting the needle into the skin.


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