FPA Beats

Editor: Dr Pragnesh Shah

Clinical Cardiologist.

Issue: June 2020

Family Physicians’ Association, Vadodara

Dr Pragnesh Shah, MBBS, PGDCC (Dip. Cardiology)

Editor,

FPA Beats,

Family Physicians’ Association, Vadodara

Dear Friends,

“Local is Vocal”

“સ્વદેશી અપનાવો, દેશ બચાવો”

“આત્મનનર્ભર ર્ારત”

It is very much patriotic and pleasant to hear but what is the reality?

Triple layered masks during first lockdown were sold at the rate of 15-20

rupees which were earlier sold for 1 or 2 rupees and N95 masks were sold at

250 rupees instead of 30-40 rupees. People are making 500 - 1000% profits in

this CORONA era. We need to change this mind set.

Dear all, future of medical field will be around life style diseases and viral

diseases. Both can be easily beaten by fitness and immunity booster activities,

body and mind nutrition status, love, devotion, meditation and inner

happiness. So we need to revisit our original culture i.e YOGA, healthy food

habits, old school games, joint family culture etc.

व्यायामात् लभते स्वासं्थ्य दीर्ाायुषं्य बलं सुखं।

आरोगं्य परमं भागं्य स्वासं्थ्य सर्ाार्ासाधनम् ॥

( व्यायाम से स्वास्थ्य, लम्बी आयु, बल और सुख की प्राप्ति होती है। निरोगी होिा

परम भाग्य है और स्वास्थ्य से अन्य सभी कायय नसद्ध होते हैं ।)

Dear all, surely this time will also end soon but it is a great learning phase for

all of us. Let’s start investing in health. Cont...

I define health as below:

Have 7 to 8 hours of sleep.

Enjoy regular vacation with near & dear ones

Add daily 45 minutes of exercise in your routine.

Leave smoking, alcohol etc.

Take adequate water & nutritive food.

Hour of happiness daily (with friends, family, hobbies & your religion.)

Jay hind, Jay bharat.

Though of the month: “निरोगी होिा परम भाग्य है!”

Yours,

Dr Pragnesh Shah, MBBS, PGDCC (Dip. Cardiology)

Clinical cardiologist,

Vadodara, Gujarat.

Email : pragnesh8399@gmail.com

Contact : +91 9426336422

Presidential Address

Dr Ketan Shah

President,

Family Physicians’ Association, Vadodara

Friends,

As all of you know that the situation due to corona virus is getting

worse day by day and all of you agree that everyone has to follow

government guidelines and to improve our individual immunity is the

top priority for us now a day’s please do regular exercise and keep

yourself fit.

At professional level we have already informed you all about the

government's stand for our professional duty. They have given us a

figure of remuneration and urge our members to come forward and

give our services. But somehow no one from our association is ready

to serve because of panic situation arising due to covid pandemic.

Although we have asked government to give our doctors duty to

covid care centres only. We are planning to have meetings with

government and our respected senior members. We are not having

full proof method of protection but still the best we can use under the

circumstances. So we have started to give tailor made double layered

masks and then surgical masks plus face shield to our members. I

think that will be useful for extra protection of our members.

Dr. Pragnesh is trying hard to give our members updated guidelines.

Friends, take care and careful for the coming months.

Thanks.

Dr Ketan Shah

President,

FPA Vadodara

Secretary Address

Dr Rikul Shah

Hon. Secretary,

Family Physicians’ Association, Vadodara

Dear members,

As we all aware, we are facing COVID-19 pandemic nowadays.

More than 60 lakhs people infected worldwide and nearly 2 lakh

persons in India. As on today we have no definite treatment or

preventive vaccine for the same. So we have to follow all preventive

steps like social distancing, wearing protective mask, hand washing

and use of sanitising techniques.

We doctors are facing more challenges as we have to treat patients

with all risks. So, please follow preventive steps and wear

appropriate PPEs and do our social duties.

Take care of yourself, your family and society.

Dr Rikul Shah Hon. Secretary,

FPA Vadodara

Kindly note that views expressed in article are author’s views. FPA,

Vadodara does not endorse author’s views.

Let’s live with the corona virus. - My views.

Dr Jayesh M. Parikh, MBBS

Family Physician, Vadodara

Being a medical professional many of my patients have asked me a

common question – “how do we come back to our normal life, what

should we do?” This question seems to be very simple and till now

many of us know much about its answer; but still thought of putting

down my views for general awareness ------ hope that my effort will

be helpful to the community.

Not going into details, let us briefly understand the common mode of

transmission of this virus. Just a small thing to add – as this is a virus

it require a living cell to multiply itself and as it can survive on

surfaces for varied span of time, once thrown out of the body of the

infected person . Now here it is very important to understand that the

infected person means a person having the virus in his body… may

be a carrier, may be asymptomatic person or may be a

patient…..depends upon so many factors. Having understood this

basic fact --- let us now understand - how transmission occurs; as

when we know these we can take precautionary measures required to

prevent the entry of virus in our body.

Commonly there are three major routes of transmission:-

1. Droplets having the virus --- this occurs when some infected

person expels out droplets while any act which involves

expelling of saliva or respiratory secretions. Like talking,

singing, crying, coughing, sneezing, shouting….etc.

2. Contact transmission --- it occurs when a normal person comes

in direct contact with the body part or any surface infected with

the virus. Here it depends upon the varied time span depending

upon the material of the surface /body part and also the most

important fact that – a person gets infected only when his own

hands or the objects having virus ( may it be transmitted by the

contact) touches any of the area like eyes, nose or mouth.

3. Air borne transmission --- this occurs when we are in the close

proximity (less than 3 – 6 feet ) of the infected person and the

virus thrown out from an infected person, again via coughing,

sneezing, singing shouting can directly enter our respiratory

system along with the normal breathing process.

Having understood the ways of transmission, let’s try to understand

and frame the ways of prevention – what we call precautionary

measures --- it will be better to go point wise taking the points of

routes of transmission.

1. For droplets:-

a. Wearing a double or triple layered cloth mask will prevent the

transmission of virus expelled, beyond the mask.

b. Compulsorily wear mask yourself and make others around you

to wear mask ---- do not go near to a person who does not have

mask on face while in public.

c. The mask should fit tightly and should cover your nose, mouth

and should go and rest below your chin (so that any drooping

from the mouth or nose stays within the mask; and the touch

protected). Do check the tight fitting of the mask by blowing

the air after wearing the mask – the air flow should not be felt

on eyes or cheeks if it is properly fitted.

d. Have 3 pairs of washable masks ---- after using it keep aside

for 1 or 2 days (without touching) then wash with any

detergents and dry in sun heat. For additional protection one

can iron it before using.

e. Discard the mask immediately if it is loosely fitting or spoiled

by our mouth secretions.

f. Avoid touching the outer exposed surface of the mask ----

remove it by holding the strips or rubber string.

g. Avoid adjusting the mask; if at all required adjust or lower

down by side borders --- but strict no for touching outer

exposed surface.

h. For the protection of eyes must wear eye glasses and avoid

touching your eyes. If going in meetings or having table work

where people come to you then advisable to wear face shield

over and above mask and eye glasses.

2. For contact transmission :-

a. Wear a cap while going out.

b. Wear washable hand gloves to cover the entire exposed part of

your hands. Same as with masks have 2 to 3 pairs and follow as

written above for masks.

c. Avoid touching publically used surfaces as far as possible. If

need to touch, try touching with other body parts and not with

hands as far as possible. Like…. You can open the door with

foot, can press lift buttons by your elbow…. The basis is to

prevent hands from getting virus transmission as we touch our

face by hands. Virus transmitted on other parts – if at all – will

get destroyed after few hours and till that time we are surely

not touching our face with that.

d. Do not touch the exposed surface of the gloves or cap with

bare hands while removing them. Always remember to remove

cap first (from back side) with the gloves still on hands…… for

removing gloves….. First fold the glove at wrist side of one

hand a little by the other hand ….. Pull it to expose the inner

side out once removed…… place the finger of your bare hand

inside the glove at the wrist side…… pull it from with in so

that the inner side is exposed and you do not touch the outer

used side.

e. Do sanitize or wash your hands every time you remove mask,

cap or gloves. Best is to sanitize by hand sanitizer while

removing these and when you are done – wash your hands

thoroughly and liberally with soap and water before touching

any surface or any person of your house. You need to open the

tap for washing hands – either other person can open it for you

or if you open it yourself then while soap is still applied over

your hands – wash the tap with the soap applied on your hands

– wait for 20 to 30 seconds and rinse tap first and then your

hands --- now tap is safe to be closed.

f. Keep a small hand sanitizer with you in your purse or pocket,

which can be used every time to sanitize the hands (with

gloves) when in public. As far as possible never wear and

remove the gloves or mask frequently while still in public.

Once wore make sure that you will remove it only after

returning home.

g. Make maximum use of small and disposable things like tissue

paper, tooth picks, match sticks….. For touching public

surfaces and immediately dispose it off properly once its usage

is over.

h. If you require to go with children, all precautions listed above

need to be followed and be extra watchful and extra careful for

the young ones as out of their ignorance they happen to touch

here and there. Also, control your emotions of expressing your

love towards them physically.

i. While returning from outside, suspect that each of your body

part, cloth material and belongings which were exposed has

had the transmission of virus ---- thus, steps to be followed

while returning home….

i. Call your family members before returning and instruct

them to keep the door open. If no one at home you can

open the door with your back or elbow or shoulders.

ii. Do not touch anything or any one until you have

sanitized yourself properly.

iii. Keep the things you have brought or you took with you

either in a corner of the room or outside your house

where no one happens to touch for 2 -3 days.

iv. Remove cap, mask, gloves …. Etc. Following proper

steps of removing and sanitizing.

v. Better if you keep a portable sprayer filled with liquid

hand and body sanitizer solution (available in market).

Tell someone to spray the same on whole of your body

front and back ---- now your outer surface gets sanitized

and no harm if you happen to touch anything. (you can

spray it yourself if no one is available)

vi. Wash your hands.

vii. Take a shower bath.

viii. Dip all your cloths in hot water having washing

detergent. It’s ok if you wash it next day.

ix. All cloths should be ironed before wearing them while

going out.

x. Foot wear left outside.

j. Avoid public transport as far as possible.

k. Maintain social distancing always.

l. When calling your supportive staff for work in house hold…..

i. Instruct them to carry bare minimum objects with her.

ii. Mask and gloves must while coming from their home;

the same asked to remove and kept outside our house.

iii. Foot wear outside our house.

iv. Hands, feet and over all body sanitized with spray

sanitizer before allowing her to enter inside.

v. Mobile and keys… etc to be kept in one corner and not to

be touched by us.

vi. Fresh mask should be given to her whom has to be worn

all throughout her stay and to be discarded by her when

she leaves our house.

vii. Social distancing maintained with her always.

viii. No one to enter the room where and while dusting and

brooming is going on.

ix. She must not touch any surface upon entering the house

and asked to wash hands immediately upon entering the

house.

x. Do not give or receive any thing (including cash) by

means of direct touch.

xi. Washing hands is must if handling cooking or caring for

the elderly.

xii. Washing of all the utensils with good quality detergent

and rinsed thoroughly is must.

xiii. Keep the utensils to be used by workers separately. That

should not be used by any of the family members ----

better to use disposables and discard the same.

xiv. Properly disinfect toilet if the worker has to use that at

your home. Avoid using the same for few hours if

workers have used.

xv. Make sure all her work is complete so that she should not

come back once she leaves our house.

xvi. Instruct them to use tissue paper /match stick for

operating lifts and to discard after usage.

m. Do not share your food or drinks even with your loved ones.

n. Make habit of frequent hand washing by any soap and water;

more so before and after handling food, eating and after usage

of toilet blocks.

o. As far as possible avoid usage of public toilets.

3. For air borne transmission :-

a. Maintaining social distancing is the most important preventive

measures.

b. Avoid running air conditioners in public places or going to

places having air conditioning as the virus travels for long

distances and also can survive longer in air conditioned

atmosphere.

c. Must to follow cough and sneeze etiquette. (Coughing or

sneezing in your folded hands – folded elbows).

In one sentence; if all wear mask properly, maintain safe social

distancing, avoid unnecessary touching of objects – transmission of

the virus can be prevented to a larger extent.

Proceeding further, suppose even after taking all possible precautions

still the virus enters our body……… then comes the second step of

defence --- our immunity.

Few points on boosting our immunity -----

1. Good general, overall health.

2. Balanced diet, high in fruits and vegetables.

3. Yoga and regular exercise at home.

4. Certain breathing exercise to improve the strength of lungs

and heart.

5. Strongly positive attitude towards life.

6. Adequate and peaceful sleep.

7. Maintain your hydration level.

8. Take food rich in vitamin c and antioxidants. (apple, carrot,

orange, lemon, grapefruits, grapes, tomatoes, watermelon, are

few ).

9. Alma and lime are richest in vitamin c.

10. Always eat freshly prepared food served hot.

11. Taking proper measures to avoid any other infection as any

disease reduce our immune levels.

12. Keep your stress levels to minimum. Indulge in all happiness

giving activities.

13. Seek medical advice immediately on having any complaints

what so ever. Let your doctor decide the treatment plan for

you for any disease --- do not self medicate.

14. Maintain adequate hygiene and cleanliness at surroundings.

15. Prefer to stay in well ventilated rooms. Let sun light enter

your room as it is a natural protection against germs and also

provide vitamin d.

What if you fall prey to the corona virus ----

1. Having slightest doubt, immediately contact government

helpline or take advice from your family physician ---- stitch

in time saves nine.

2. Follow the advice given by the covid 19 treating doctors

strictly.

3. Isolation / quarantine is the modality to protect you and your

loved ones. More over it increases the quality of care

provided to the patients.

4. Do not panic at any level.

As a responsible citizen I emphasize upon and request all to be

updated and follow government guidelines for the fight against

corona.

Let us not panic…..let us be informed……let us act wisely…….let

we learn to stay safe and healthy .

Wishing good health.

હ ેમાધવ, ત ુઆવી જા....

કમભનો ધમભ માનવ સમાજે નવસરાયો છે,

સ્વાર્ભ જ ચારેકોર આજે પર્રાયો છે,

"જાત જ પ્રર્મ" નનયમ સ્વીકારાયો છે.

હ ેમાધવ, ત ુઆવી જા....

તારી હાજરી કમૅયોગીને પ્રેરશે જરૂર,

સારા દુયોધનો ધમભ તરફ વળશે જરૂર,

ધમભ સ્ર્ાપના કાજે ફરી તારી છે જરૂર.

હ ેમાધવ, ત ુઆવી જા....

કમભની મહત્તા એકવાર ફરી સમજાવી જા,

જે કાાંઈ નનષ્ક્રિયતા છે, પાછી સધુારી જા,

હ ેનમત્ર, બહ ુર્યુાં ત ુહવે તો આવી જ જા.

હ ેમાધવ, ત ુઆવી જા....

ડૉ પ્રજ્ઞેશ શાહ, MBBS, PGDCC (Dip. Cardiology)

કલીનનકલ કાર્ડિયોલોજજસ્ટ,

વડોદરા.

CORONA gives us following messages

Close nose & mouth by mask

Obey government notification

Rest adequately

Observe social distances

Nourish your body and mind properly

Aware society and accept challenges

For during and after CORONA era