Depression in teenagers: Talk to them

What is the need?

Worldwide 10-20% of children and adolescents experience mental disorders & behavioral problems. Half of all mental illnesses begin by the age of 14 and 70% by mid-20s.

• Depression is the single largest contributor to the global burden of disease for people aged 15–19,
• Suicide is one of the 3 leading causes of mortality among people aged 15–35.
• Worldwide around 71,000 adolescents commit suicide annually, while up to 40 times as many make suicide attempts.
• Neuropsychiatric conditions, if untreated, these severely influence children’s development, their educational attainments, and their potential to live fulfilling and productive lives.

What is the cause?

The increase in mental disorders is attributed to disrupted family structures, growing youth unemployment, and families’ unrealistic educational and vocational aspirations for their children.

What is depression?

Depression (major depressive disorder) is a medical illness that can interfere with the ability to handle the daily activities, such as sleeping, eating, or managing the school work. 

• It is common but that doesn’t mean it isn’t serious. 
• Treatment may be needed for the person to feel better. 
• It can happen at any age, but often symptoms begin in the teens or early 20s or 30s. 
• It can occur along with other mental disorders, substance abuse, and other health conditions.

What are the symptoms/signs of depression?

The following are typical characteristics:

• Persistent sadness, boredom, and low energy
• Severe sleeping problems
• Eating disorders and weight changes
• Apathy towards friends, school, and family
• Sense of worthlessness
• Difficulty concentrating
• Deterioration in school performance
• Crying, emotional ups, and downs
• Complaints about physical symptoms such as headache
• Acting out and risk-taking behavior
• Preoccupation with death and dying
• Suicide attempts (called parasuicide)
• Difficulty in self-motivation
• Unnecessary aggression, anger, and rage
• Over-reaction to criticism
• Feels incapable of living up to the parental expectations
• Lacks self-esteem and suffers from guilt

What are the risk factors?

• Depression in a close relative
• Major life stress (examples follow)
• Recurrent stresses
• Bullying
• Broken relationship
• Child abuse
• Family break-up
• Substance abuse (e.g. alcohol, marijuana)
• Social isolation—due to race or sexuality
• Sexual maladjustment
• School failure
• Health problems
• Unemployment

How to help a depressed teenager?

• Listen to them and be alert to what they are saying and not saying
• Treat them with respect.
• Take their problems and depression seriously.
• Offer unconditional love and support.
• Be available to help when requested.
• Be flexible and consistent.
• Encourage them to express their true feelings.
• Encourage them to do things that they enjoy

Advice for parents, carers, and friends:

• Follow the above guidelines. 
• Encourage your child to get help without nagging or being judgemental 
• Ask people close to you for advice and support. 
• Do not cling to your child or show too much concern. 
• Look closely at your own management style and skills 
• Ask yourself whether you could improve or alter your approach 
• Take any talk about self-harm, including suicide, very seriously
• Make sure your child’s environment is safe.
• Professional support
• Ask your general practitioner for help 
• Encourage your child to see that it would be in his or her best interests to get help. 
• The excellent treatments available include counseling and antidepressant medication, if necessary

References:

1. https://www.unicef.org/sowc2011/pdfs/Adolescent-mental-health.pdf
2. https://www.who.int/maternal_child_adolescent/topics/adolescence/mental_health/en/
3. https://www.who.int/news-room/fact-sheets/detail/adolescent-mental-health
4. https://www.nhp.gov.in/healthlyliving/adolescent-health-10-19-years
5. https://www.nimh.nih.gov/health/publications/teen-depression/index.shtml
6. https://qbi.uq.edu.au/brain/brain-diseases/depression photo credit
7. https://www.nami.org/NAMI/media/NAMI-Media/Infographics/NAMI-Getting-the-Right-Start.pdf photo credit
8. https://twitter.com/UN/status/1173220672429903872/photo/1 photo credit
9. https://www.nami.org/NAMI/media/NAMI-Media/Infographics/NAMI-Getting-the-Right-Start.pdf photo credit

Health Management: An Introduction

What is Management?

In simple words, Management is getting things through & with people. 

• It is about getting the right work done, by the right person, using the right amount of resources, at the right time, and with the use of the right methods.
• It is to attain effectively predetermined results (objectives/goals) by managing all available resources efficiently with changing the external environment.

What are the various definitions?

Health management is defined by a number of experts as:

F W Taylor: "Management is the art of knowing what you want to do and then seeing that it is done in the best and cheapest way."

Henri Fayol: "To manage is to forecast and plan, to organize, to command, to coordinate and control."

Peter F Drucker: "Management is a multi-purpose organ that manages a business and manages managers and manages workers & work."

Harold Koontz: "Management is the art of getting things done through and with people in formally organized groups. It is the art of creating the environment in which people can perform and individuals can cooperate towards the attainment of organizational goals. It is the art of removing blocks to such performance and a way of optimizing efficiency in reaching goals.”

George R Terry: “Management is a distinct process consisting of planning, organizing, actuating and controlling, performed to determine and accomplish stated objectives, by the use of human beings and other resources.” 

What is Health management?

Health management or healthcare management is the process of organizing and coordinating the performance of a healthcare facility. 

• Supervision of the business and administrative aspects of a health care institution and 
• Taking Responsibility for the overall internal healthcare system, including clinical and non-clinical staff, partner organizations, insurance companies, government bodies, etc.

What are the elements of management?

• Resources
• Process (action)
• Results (objectives & goal) achievement 
• Effectiveness and
• Efficiency

What are the basic activities of management?

• Planning: Determining what is to be done
• Organizing: Setting up the framework or apparatus and making it possible for groups to do work
• Communicating: Motivating people to do work
• Monitoring (controlling): Checking to make sure the work is progressing satisfactorily

Why is it needed for doctors to study management?

Doctors are leaders of the health care system  just like any

other organization with its unique organizational objectives,

which have to be attained through sustained efforts of all the

members.

• Doctors are expected to lead a highly professional team of trained health care workers. 
• Activities like vaccination drive in a village or highly complicated surgery have to be planned well in advance. 
• They have to carefully select the team members & motivate them to perform.
• The understanding & skill of management amongst the doctors are needed in the healthcare delivery system may be from M.O at PHC to the director at the state, country & international level.
• Now in the private sector also multispecialty hospitals are coming up which can be better managed if a doctor has a better understanding of management.

References:

1. Park, K., 2019. Park's Textbook Of Preventive And Social Medicine. 25th ed. Jabalpur: M/s Banarsidas Bhanot Publishers, p.1000.
2. Kadri, A., 2019. IAPSM's Textbook Of Community Medicine. 1st ed. New Delhi: Jaypee Brothers Medical Publishers (P) Ltd, p.1221.
3. Sathe, P., 2018. Epidemiology And Management For Health Care. 5th ed. Mumbai: Vora Medical Publications, p.508.
4. Bhalwar, R., 2009. Textbook Of Public Health And Community Medicine. 1st ed. New Delhi: Department of Community Medicine, AFMC, Pune in collaboration with WHO, India office, p.1302.
5. https://www.who.int/management/en/
6. https://inspiria.edu.in/difference-between-hospital-management-and-healthcare-management/ photo credit
7. https://www.google.com/urlsa=i&url=https%3A%2F%2Fwww.pinterest.com%2Fpin%2F617626536372266067%2F&psig=AOvVaw0PQu_1i0IYb1lOqwls_48M&ust=1601474417029000&source=images&cd=vfe&ved=0CA0QjhxqFwoTCPDHiKLDjuwCFQAAAAAdAAAAABAN photo credit

World Heart day 2020: Use Heart to beat cardiovascular diseases

What is the need?

As per WHO, Cardiovascular diseases (CVDs), are the number 1 cause of death globally, take the lives of 17.9 million people every year, 31% of all global deaths (half of all non-communicable-disease related deaths); and over 23 million predicted deaths from CVDs by 2030. WHO has a target to reduce premature deaths from non-communicable diseases (NCDs) 25% by 2025, of which CVDs make up the largest proportion. Hence, we need to take care of our hearts.

What are Cardiovascular Diseases?

CVDs are a group of disorders of the heart and blood vessels that supply blood to the lungs, brain, kidneys, and other parts of the body. CVDs include 

• Coronary heart disease, cerebrovascular disease, rheumatic heart disease, and other conditions 
• Four out of 5CVD deaths are due to heart attacks and strokes 
• One-third of these deaths occur prematurely in people under 70 years of age

When is it celebrated?

World Heart Day is organized by the World Heart Foundation on September 29 each year to inform people about cardiovascular diseases (CVDs) & spread awareness for preventive measures to reduce the risk of CVDs. It aims to motivate people that by controlling risk factors such as tobacco use, unhealthy diet, and physical inactivity which can prevent at least 80% of premature deaths from heart disease and stroke. The theme for this year is "Use heart to beat cardiovascular diseases". Use heart is about using

• Your head: To understand what is a heart-healthy lifestyle & change your behavior accordingly.
• Your influence: To set an example & change the attitude of people
• Your compassion: To look beyond the self & support the vulnerable people

What are the preventive measures?

Many CVDs are preventable by addressing 

The behavioral risk factors such as-

• Healthy diet: Take a diet with fruits, vegetables, grain products, lean meat, and fish as well as limit the consumption of animal fat, sugar, and salt.
• Do not smoke and do not be near people who smoke.
• Exercise regularly: Every day for 30 min in order to accelerate the heart rate and breathing. 

Continuous monitoring and control-

• Blood pressure, like hypertension (high blood pressure), may cause myocardial infarction
• Blood sugar levels especially if you have diabetes.
• Blood cholesterol since high cholesterol increases the risk of myocardial infarction.
• Carefully take the medication- Take your medicines regularly as prescribed by the Doctor.

Keep track of your progress and feel proud of what you do for your own and family’s health.

What are the warning signs of a heart attack?

• Mild pain or discomfort in the center of the chest that lasts more than a few minutes
• Pain or discomfort in one or both arms, back neck jaw, or stomach
• Shortness of breath
• Cold sweat, nausea, lightheadedness

What is the first aid for heart attack?

• Allow the victim to sit up, or in the position that is most comfortable.
• Loosen any tight clothing.
• Ask if the person takes any chest pain medicine, such as nitroglycerin for a known heart condition, and help them to take it.
• If the pain does not go away promptly with rest or within 3 minutes of taking nitroglycerin, call for emergency medical help.
• Take the victim to the hospital as soon as possible.

References:

1. https://www.who.int/cardiovascular_diseases/world-heart-day/en/
2. https://www.nhp.gov.in/world-heart-day,-2018_pg
3. https://www.who.int/health-topics/cardiovascular-diseases/#tab=tab_1
4. https://www.world-heart-federation.org/world-heart-day/world-heart-day-2020/
5. https://www.who.int/cardiovascular_diseases/World-heart-day-2017.jpg?ua=1 photo credit
6. https://www.who.int/cardiovascular_diseases/Social_squares_20182.jpeg?ua=1 photo credit
7. https://www.who.int/cardiovascular_diseases/1-billion.jpg?ua=1 photo credit
8. https://www.who.int/cardiovascular_diseases/Reduce-CVD-risks.jpg?ua=1 photo credit
9. https://www.who.int/cardiovascular_diseases/Affordable-medication.jpg?ua=1 photo credit
10. https://www.who.int/cardiovascular_diseases/Resolve.jpg?ua=1 photo credit
11. https://www.who.int/cardiovascular_diseases/Global-hearts-initiative.jpg?ua=1 photo credit

Carcinoma Penis: Diagnosis and Management

 

How to prevent dog bites?

Points to remember for preventing dog bite?

References:

1. https://www.who.int/rabies/resources/Five_tips_to_prevent_dog_bites_poster.pdf?ua=1
2. https://www.who.int/rabies/resources/educational_material_children/en/
3. https://rabiesalliance.org/resource/want-friend-be-friend-english
4. https://www.tes.com/teaching-resource/dog-bite-prevention-6369120
5. https://www.doo-n-go.com/preventing-dog-bites/