BMI, health and wellness, obesity, weight

Obesity- A real problem??

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Dr Qazi Arif

Are you always being teased by your friend as obese?
Does your spouse always insist you to lose some weight?
Are your clothes becoming tighter day by day?
Are you really worried being obese?
If answer to any of the question is YES then go on reading
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What does overweight or obesity mean?
“Excessive fat accumulation that is hazard for health is obesity”

Why a person becomes obese?
Obesity is usually the result of an imbalance between calories consumed and calories expended by a person.
A combination of increased consumption of highly calorific foods, without an equal increase in physical activity that leads to a positive energy balance which causes increase in weight.
What we eat should be expended or else it leads to excess.
How some persons put on weight despite dieting or regular exercise? That can be explained on the basis of their genetic susceptibility.
A few cases are caused by some endocrine disorders, medications, or mental illness, stress or some genetic diseases.
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What is the current trend?
Obesity is one of the leading causes of death worldwide, with increasing rates in adults and children particularly in urban areas. Evidence suggests over the last 35 years, the no. of obese people has become double. In modern era easily accessible and palatable diet, increased use of vehicles and mechanized manufacturing are the possible causes.
Obesity is more common in women than men. Earlier obesity was supposed to be symbol of wealth (
) but now scene has changed and everybody wants to be slim n fit due to increased awareness about hazardous effects of obesity.
Obesity and Diet
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Our diet consists of mainly carbohydrates proteins and fat. And it is observed that most of the extra food energy comes from an increase in carbohydrate consumption rather than fat consumption. The primary sources of these extra carbohydrates are consumption of fast foods, sweetened drinks such as soft drinks, fruit drinks, and energy and potato chips etc. is believed to be contributing to the rising rates of obesity.
Sedentary lifestyle
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Another important factor that plays significant role in obesity is sedentary lifestyle. Day by day world is shifting towards less physically demanding work, in addition to insufficient exercise. Increasing mechanized transportation and a greater prevalence of labour-saving technology in the home also making the things easy for obesity. Spending leisure time in front of television cannot be ignored.
Other illnesses

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Credits: glamcheck.com

Certain physical and mental illnesses and medicines used to treat them can increase risk of obesity.
Certain medications may cause weight gain or changes in body composition; these include some medicines used against diabetes, psychiatric diseases depression, convulsions. Not all but some commonly used medicines also contribute to it. Some forms of hormonal contraception and steroids are also responsible factors.
How it is diagnosed?
Whenever any person asks me, am i obese? Then as a doctor asking simply weight of that person is not enough, we ask height also so that we can calculate BMI. If 2 persons are having same weight, one can be obese and can have other normal weight, its due to difference in their heights.
Now what is BMI?
Body mass index (BMI) is a commonly used tool used by us to classify overweight and obesity in adults.
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BMI is the weight in kilograms divided by the square of the height in metres (kg/m2).
Depending on that person is classified into different categories:
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So our goal should be to keep the BMI in the range of 18.5 – 24.9.
WHO defines overweight as a BMI equal to or more than 25, and obesity as a BMI equal to or more than 30.
Advantage of using BMI is that it can be used for both males and females and give rough estimate of your obesity status. But BMI cannot suggest the total body fat so we have other parametres.
Waist circumference
It is a simple and practical method of identifying overweight people who are at increased risk of obesity. It’s a good screening tool and does not depend on height.
Correct method to measure your waist circumference is:
1. In standing position place a measuring tape around your middle, midway between your lower point of rib and highest of your hipbones.
2. Keep the tape horizontal around the waist.
3. Do not compress the skin but keep the tape snug.
4. Just after you breathe out take the reading.

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Credits: whyiexercise.com

If waist circumference is greater than 40inches for men and 35inches for women, it means they have excess abdominal fat, which puts them at greater risk of health problems, even if their BMI is about normal.
Waist to Hip Ratio (WHR)
Calculation of WHR is easy and you can easily do at your home. It’s better to have lower waist-to-hip ratio as more the WHR more is the risk. If you are wider at the waist then more is the chances to have obesity related health problems.
Women with a waist-to-hip ratio of 0.8 or less, or men with a ratio of 0.9 or less, are considered “safe.” A WHR of 1.0 or higher, for both gender, is considered “at risk” for overweight-associated health problems.
How to calculate WHR
Measure waist circumference with the technique as above then write it down.
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Now again in the standing position wrap a flexible tape measure around your hips below the most prominent bony point as shown in the picture.
The resulting measurement is your hip circumference. Again, write it down.

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Credits: whyiexercise.com

Divide your waist circumference by your hip circumference. The result is your waist-to-hip ratio or WHR.
For example: A waist measurement of 30 inches (75 cm) divided by a hip measurement of 36 inches (90 cm) would calculate to a WHR of 0.83.
So I have provided you the methods, now just apply it and see are you really obese???
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burn, dowry, f3male foeticide, india, social

Y chromosome or WHY chromosome???

At 2am, ward boy knocked the  doctor’s room door…..
“Sir new patient” he shouted from outside.
I got up and opened the door. He further informed “burn patient”
“Ok I’m coming” I told after opening the door.
It was really the coldest night of the season. Everybody was wearing either shawl or sweater. At the peak of coldness, I was very lazy, but still I had to do attend that patient.
I rushed to emergency room, the patient was young female, on asking details, she was KUSUM A NEWLY MARRIED BURN PATIENT. Burnt from top to bottom, asking for water. She was so thirsty that she could drink whole the river. Screaming in agony.
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Those who were accompanying her told that after sunset, they found her naked on the front step of her house where she was living with her husband and in-laws on the outskirts of the city.
She was burnt more than 80 per cent of her body. The only places not burned were the inside of her arms, her ankle, some part on her belly and the area around her eyes. However, her scream was more horrible than her charred body. Wrapped in blankets and burnt saree, one could hardly see normal skin. Kerosene smell was making its presence felt.
On inquiring, persons which were accompanying her were her neighbours. They were looking puzzled.
When I examined her, she was cold like a dead body, pulse was barely palpable.
I was not getting any vein as If all her blood was dried up. Limbs were swollen. I did emergency venous cutdown (emergency proceduere where skin is cut and cannula is put in the vein under vision). My aim was to give her fluid so that she should not dry up. She was in agony, nursing staff was active enough to give her necessary injections and pain relieving medications which I advised.
With initial medications we somehow managed to give her some relief with saline administration in jet.
By this time, her parents came to the hospital, I was standing beside her doing necessary management. Her mother entered yelling. She was crying like anything “maine kaha tha myke aa ja lekin wo nahi mani”
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I didnot tell her anything I was just watching this worst part of her emotions. Father who was standing behind wasnot saying a single word but his eyes were expressing all his emotions. Continuously flowing tears were making his emaciated face more worried. Mother was shouting continuously “wo log insan nahi hai, bhagwan unko saza de kr hi rahega”
Her father came to me and asked “meri beti ko bacha lo”
I had no words but I had to tell him something I told “Hum bachane ki poori koshish kar rahe hai lekin….”
I was looking at his face and i dont know why it was very difficult for me to utter these words. But i continued after a pause “…Lekin bachne ki ummid bahot kam hai”
He told with his dried tongue “docto sahab koi bhi dawa do chahe kitni bhi mehangi ho mai laane ke liye tayyar hu”.
I was looking at his poor face i knew he would sell himself but will arrange something to buy that medicine but it was unfortunate that nowhere in my medical books i read any medicine which could save his daughter.
Her father showed me her wedding picture, she was a cute village girl, wearing red saree with bridal makeup. But now she was a charred body, hardly one can see her facial features.

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This pic does not represent real kusum

I asked him how this has happened??
He told “my daughter got married last year. It was the mightiest wedding cermony in his village. For initial few months everything was perfect, then her in laws started pressuring her for dowry.
They started asking for cash, gold to start new business. They told the money which i gave at the time of wedding was not sufficient though i gave what was decided earlier.
Gradually demands for money turned to threats of violence, they started beating her often and now see what they have done this time”. He started crying like a kid.
I was not brave enough to stay there and see the worst side of our society. I left the place.
I knew she has very less chance of survival and even if she survives its going to be a roller coaster ride for all.
About 2hours later she took her last breath infront of me, and i was standing helplessly witnessing another dowry death.
This story doesnot end here, it is the same repeated story you can find in any government hospital of India. Statistics say one woman die of dowry death every hour in India, more than 8000 women a year according to National Crime Records Bureau (NCRB).
You might think this only affects poor, uneducated people but higher socio-economic strata is equally involved in such practices. Even the highly educated class of our society do not say no to dowry. It runs deep into our social system and most of the time dowry deaths are not reported.
Though dowry is not a new word for Indian but if we define it ‘Dowry is the sum of all the money as well as other items such as jewellery, car, furniture, and house, etc., given by the bride’s family to the groom and his family.’
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But greed is limitless, which many a time leads to either suicide in some cases or murder in some.
Though feminist groups are active in increase awareness regarding the problem of dowry, dowry harassment and dowry deaths. They devise strategies.
Government is also making efforts to stop this worst custom of dowry.
The Section 304-B, IPC deals with the Dowry Prohibition Amendment Act. Apart from this Act, we also have Protection of Women from Domestic Violence Act, 2005.
Despite all these getting dowry death cases are the usual phenomenon. Its a social evil which should be stopped.

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Here are some of my suggestions and solutions to tackle the situation.

1. Awareness: The prime solution to the problem of dowry deaths is awareness. Women should be taught about her legal rights and this can be achieved by setting up some awareness programmes in different sections of the society.
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2. Education: alternative approach to increase awareness by educating people about such issues and imbibing such social issues into the curriculum of primary education.
3. Strict punishments and speedy trials of the cases: heavy punishment to the people convicted of crime related to dowry can also help to creat deterrent effects. In addition speedy trials will surely help the victims.
4. Enforcement Mechanisms to be strengthened:
Though we have many laws against it but still the problem of dowry demand continues, now it is the time to strengthen the enforcement of these legislations.
5. Intellectual people should play an active part. So many blogs/articles or even books can be written on this topic but now enough is enough. All of us especially young people should take initiative. We can start campaign with the use of social media. Take positive steps to “STOP DOWRY DEATHS”.
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cancer, health and wellness, india

Kill cancer before it KILLS YOU…

Written by: Dr Arif Qazi
                                         

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One disease, which everybody feared of is CANCER. In modern era, we are surrounded by so many factors which directly or indirectly cause cancer. Many a time we know the direct association of certain substance ingestion or use with cancer still we take a chance and continue to use them, underestimating the risk. I would say only a fool can take risks to such an extent that his/her habits take his/her own life.
Here I am presenting the most common example how people make a fool out of themselves….

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Credits: medicalnewstoday.com

First lets know What is cancer?
Cancer is uncontrollable growth of cells that invade and cause damage to surrounding tissue.

What is Oral (mouth) cancer?
Oral cancer is the 3rd the most common type which accounts for over 30% of all cancers in India. Almost 80,000 cases are diagnosed every year.
According to the report, almost one million people die of oral cancer in India yearly.
Oral cancers include cancers of the:
lips
tongue
cheek
gums
floor of the mouth
hard and soft palate.

Most of the time, patient comes to the hospital in late stage but Early detection is the key to for better results.
Who are at risk of oral cancer?
1) Tobacco use in any form like smoking cigarettes, bidi, cigars, and pipes, as well as chewing tobacco quid, khenni.

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•Another major problem is the use of betel quid (paan), which is made of pieces of areca nut, processed or unprocessed tobacco, aqueous calcium hydroxide (slaked lime), and some spices wrapped in the leaf of piper betel vine leaf. Gutka, zarda, kharra, mawa, and khainni are also all dry mixtures of lime, areca nut flakes, and powdered tobacco.
•Bidis: Those who smoke bidis have a three-fold higher risk of mouth cancer as compared to nonsmokers.

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2) Alcohol intake: People who take large amounts of alcohol and tobacco are at greater risk, especially when both products are used regularly.
Risk increases when both (tobacco and alcohol) taken together.
3) Other risk factors include:
HPV infection (a sexually transmitted virus)
• Chronic facial sun exposure
• Previous diagnosis of oral cancer
Family history of oral or other types of cancer
Sharp tooth
• Chronic Syphilis
Poor nutrition
• Being male
Age more than 40yrs

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There are studies, which indicate a diet low in fruits and vegetables could be a risk factor.
What are symptoms of oral cancer?
Symptoms of oral cancer include:
•a sore on the lip or mouth that does not heal
•a mass or growth anywhere in the mouth
• white or red patches in mouth or lips

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Credit: dentallecnotes.blogspot.in

•bleeding from the mouth
•pain or difficulty in swallowing
•loosening of teeth and difficulty in wearing dentures
•swelling in the neck
•ear pain that won’t go away
•sudden weight loss
•numbness in lower lip, face, neck, or chin
•Difficulty in opening mouth

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Credits: http://www.draxelraf.com

If you notice any of these symptoms, especially if they persist, or you have more than one at a time, visit your dentist or doctor as soon as possible.
White/red patch in the oral cavity or thickening of inner side of cheek causing restricted mouth opening, are curable conditions. If left untreated can lead to cancer.
How is oral cancer diagnosed?
1) Thourough physical examination by doctor. This includes closely examining the whole the oral cavity. lips, tongue, cheek, gums, floor of the mouth, hard and soft palate.
2) If your doctor finds any abnormality, he may perform a biopsy. A tissue biopsy involves removing a piece of the tissue so it can be examined under a microscope for cancerous cells.

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Credit: oralcancernews.org

3) In addition, your doctor may perform one or more of the following tests:
•X-rays to see if cancer cells have spread to other parts of the body.
•CT scan to know further details of spread of cancer.
•OPG etc.
What are the stages of oral cancer?
There are 4 stages of oral cancer. early stages i.e. Stages 1 and 2 usually involve a small tumor. In these stages, cancer cells are limited and have better results.

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http://www.dimitroulis.com

Stages 3 and 4 are considered advanced stages of cancer. In these stages, tumors are large and the cancer cells usually spread other parts of the body. It has the worse outcome.
So early diagnosis and timely treatment are the key of good results.
How is oral cancer treated?
Treatment for oral cancer depends on the type, location, and stage of the cancer at the time of diagnosis.
●Early stages can be treated by surgery to remove the tumor and cancerous lymph nodes.
In addition, other tissues around the mouth and neck may be taken out.
●Radiotherapy where cancer cells are destroyed with radiations is another option.
●Chemotherapy is treatment with drugs that kill cancer cells. The medicines are given either orally or through an intravenous (IV) line.

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Jofs.in

●Proper nutrition is also an important part of your oral cancer treatment. As surgery or other treatment make it difficult or painful to eat and swallow, and poor appetite and weight loss are common getting proper nutrition is very important part of treatment.
●Last but not the least keeping good oral hygiene during treatment is very crucial.
●While recovering from oral cancer treatment reconstruction of mouth, bones may be required, which are removed during surgery for better cosmetics and functional purpose.
●Speech therapy can also be required after excising tongue or other mouth parts.
●Psychological support is utmost important during whole the process.
How to Prevent Oral Cancer?
To prevent oral cancer:
1. Don’t smoke or use any tobacco products
2. Stop drinking alcohol or drink in moderation
3. Eat a well-balanced diet.
4. Limit your exposure to the sun.
5. Conduct a self-exam at least once a month.

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Credit: http://www.sixstepscreening.org

▪Using a bright light and a mirror, look and feel lips and front of gums.
▪Tilt head back and look at and feel the roof of mouth. See the cheeks.
▪Take out tongue and look at all sides. Examine the floor of mouth. Look at the back of the throat.
▪Feel for swelling orenlarged lymph nodes in both sides of neck and under your lower jaw.
6. Visit a doctor immediately if you notice any abnormality.
7. See your dentist on a regularly. Doctor is always the best person to identify any abnormality.
8. Second-hand smoke is also an issue so protect yourself from being a passive smoker.
9) maintain good oral hygiene.

I hope this blog will help you to understand and prevent this deadly disease.

Warning : click here to see the pictures of oral cancer patients. These pictures may cause distress to your mind. My poupose of showing these photos only to show you the graveness of this disease.

health and wellness

Largest Terrorist group of india…. Beaware!!!

By Dr Qazi Arif

All over the world, terrorism is a big problem but in India one terrorist group is very active, working day and night.These terrorists are all around us every time; we ignore them, but they are waiting for a single chance.

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It is said that ‘Terrorism has no religion’ , but they work as a unit. They are neither Muslims nor Hindus yet they are in a large number and many Indians help them to grow against their own people. Though some people do fight against them, but their efforts are restricted to themselves and their family only.
This terrorist group kills many people and affect so many people every single day.
Here I’m going to share their information, their locations, appearances, their activities and also strategies to eradicate them.
They work for different groups such as,
• Al-zika,
•lashkar-e-chikungunya,
•malaria night riders,
•fearless dengues
•Japanese evils etc.
Yes, They are Mosquitoes.
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Statistics say
○Buffalos kill 7 people every year.
○Lions kill 500 people every year.
○Spiders kill 5000 people every year.
○Scorpions kill 7000 people every year.
○Snakes kill 10000 people every year.
Guess what?
Mosquitoes kill 2.7 million people every year.
The smallest are the deadliest.
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There are about 3,500 different mosquito species worldwide. However, not all of them bite humans.
■Major groups which are of health importance-
1. Anopheles Mosquito
Anopheles mosquitoes commonly bite at night and rest indoors and outdoors during the day.
Females are the activists.
Anopheles mosquitoes are transmitters of Malaria.
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2. Culex Mosquitoes
Culex mosquitoes are transmitters of Japanese B Encephalitis, a very dangerous type of brain fever. They take a rest before and after blood meals and bite at night. They breed in polluted stagnant water, in India mostly in drains.
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3. Aedes Mosquitoes
Unlike others, Aedes mosquitoes (tiger mosquitoes) are active during the day. They breed in clean water in artificial containers, such as flower pots, water accumulation in tyres and cans.
Aedes mosquitoes are responsible for Chikungunya and Dengue.
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Though it is not well established how mosquitoes identify human beings, but it is supposed that
•Mosquitoes find hosts by detecting body heat and chemical signals
•Blood group O more than A and B
•Those who exhale more CO, e.g. pregnant.
■Activities
○Al-zikas: This group works at the international level. Although its activists are present in India but they are yet to attack here. So while traveling overseas protect yourself and your family from Al-zikas with the help of repellents.
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Aedes aegepty mosquitoes spread the zika virus through their bites. Thus causing fever, rash, joint and muscle pain, or red eyes. Often the symptoms are generalized discomfort lasting for several days to a week.
Infrequently, hospital admission is required, and deaths are rare. CDC (Anti terrorist squad for mosquitoes) has issued a travel notice for the people who are visiting to high alert zone for zika virus. As zika produces birth defects in babies born to women who were infected during pregnancy period with zika virus.
Considering these CDC has recommended followings precautions
•Pregnant women should not travel to any area where Zika virus is spreading.
•Pregnant women who must travel to one of these areas should talk to their doctor first and strictly follow steps to prevent mosquito bites.
•Women trying to become pregnant, and their male partners, should consult with their doctor before traveling to these areas and strictly follow the advices.
To date, there is no known vaccine to prevent or medication to treat the Zika virus infection.
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○Laskar-e-Chikungunya:
Chikungunya spreads through the bite of the Aedes aegypti mosquito, which also causes dengue. Symptoms typically start four to eight days after being bitten.When a patient is infected with chikungunya virus it produces sudden onset of a high fever and joint pain. Other symptoms may include headache, muscle pain, joint swelling, or rash.
Infection with chikungunya virus is rarely fatal, but the joint pain can often be severe and debilitating.
It is said “Chikungunya is generally not fatal, but the painful symptoms have led people to say ‘It won’t kill you, but it may make you wish you were dead!’”
Most patients recover in about a week, although long-term joint pain occurs in some people.
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They have repeatedly attacked in countries of Africa, Asia, Europe, and the Indian and Pacific Oceans. According to statistics in last 2yrs chikungunya has spread to 45 countries and almost 2 million cases have been reported.
Originally from Africa, chikungunya recurred in India after 32 years in 2006 with cases reported in India.
There is currently no vaccine or drug treatment.
○Fearless Dengues:
Forty percent of the world’s population lives in an area which are at the threat of dengue. It is estimated that 390 million people per year are infected with the viruses.
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Fearless Dengue transports the dangerous dengue virus which are of four types (dengue virus 1, 2, 3, or 4), and it is possible for someone to get dengue up to four times from 4 different types of viruses. Dengue is a leading cause of illness and death in the tropics and subtropics. Most people infected with dengue have mild or no symptoms.
25% people who are infected with dengue will develop some symptoms of disease. Mild symptoms of infection begin with a fever and severe headache, pain behind the eyes, joint and muscle pain, and rash. There can be dengue haemorrhagic shock and multi-organ failure.
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Dengue symptoms can quickly become severe and even fatal. Early recognition of severe disease and prompt treatment is the key.
○Malaria night riders:
Malaria is a life-threatening disease. It’s typically transmitted through the bite of an infected Anopheles mosquito. Malaria infection caused by four different species of a parasite Plasmodium (P) — P. falciparum, P. malariae, P. vivax, and P. ovale. Of these, P falciparum infection is the deadliest as it affects the brain and is most likely to cause death.
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Malaria is typically found in tropical and subtropical climates as it is favourable for parasites. The World Health Organization (WHO) estimates that about 3.2 billion people are at risk of malaria.
Common symptoms of malaria include:shaking chills, high fever, profuse sweating, headache, nausea, vomiting, diarrhea. Other symptomes includes anemia, muscle pain, convulsions and coma.
○Japanese evils and filariasis gang are other groups for them government has made different programms to control them.

■Let me tell you how to protect yourself and eradicate theses terrorists
In India, No matter what ever the weather is, there are always mosquitoes around.
They are practically every where in India. The main reason is mismanagement of open spaces and collection and stagnation of water thus creating a breeding area for mosquitoes.
•Before coming to India many tourist prefer to get anti malaria vaccine. This is a smart move.
The solution to mosquitoes that is available in India is simple and yet very effective.
1. Make a shield around you
•Cover-up with a loose, light colored, long sleeved shirts and pants. If possible wear socks.
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•Apply mosquito repellent to exposed skin. Avoid putting near eyes and mouth,or over cuts or broken skin.
•Use mosquito nets
• Stop adult mosquitoes entering the home by using screens on windows and doors.
2. Locate their breeding sites and eradicate them
•Potential mosquito breeding sites around the home should be removed.
•Mosquitoes need water to breed and some mosquitoes can breed in very small amounts of water.
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•Clean up backyard and remove all water-holding things including tires and containers
•Fill pot plant bases with sand to avoid standing water
•Keep drains and roof guttering clear and running to avoid stagnation of water.
•Add few drops of mineral oil (crude oil, kerosene oil, diesel, fuel oil) to the stagnant water. It kills larvas of mosquitoes.
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•Properly cleaned and chlorinated swimming pools or other water tanks are rarely a source of mosquito breeding but neglected pools can be a source of mosquitoes.
●Introduce mosquito fish (Gambusia affinis) or guppies into garden ponds to eat mosquito larvae.
3. Take extra precaution when you are travelling to high risk area
•Take all the above mentioned protections, in addition to that.
•Stay and sleep in clean air-conditioned rooms which are screened.
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•Use a bed net. Nets are most effective when they are treated with a pyrethroid insecticide, such as permethrin. Purchase it before travelling.
4. Instruction for children
•Use according to directions on the repellent. Some products are not safe for kids. Always check the product label for recommended age use.
Never allow young children to apply their own repellent.
5. Pregnancy and breast feeding
Mosquito repellents are considered safe and should be used according to product label instructions
6. Use appropriate insecticides
Aerosol insecticide sprays, mosquito coils (good for outdoors) and vapourising mats (good for indoors) are effective to repel mosquitoes.
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These products should be used in addition to, not in place of, other measures such as appropriate clothing and skin repellents.
7. Devices that use light to attract and electrocute insects have not been proven to be effective against mosquito.
8. Take extra care during peak mosquito biting hours especially around dawn and dusk to reduce the risk of infection. The mosquitoes that transmit diseases such as dengue, chikungunya, Zika will bite all through the day. The mosquitoes that transmit malaria are most active at dawn and dusk, and into the evening.
9. Mosquito-repelling smartphone apps sound too good to be true, there is no evidence that the ultrasonic frequencies they emit will actually repel the mosquitoes.
If we all work together to fight against them, we can make safe and healthy India.
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**For international readers my advice is don’t worry about mosquitoes when you travel to India. Just follow the advice mentioned and have safe stay.

You may also like: Don’t kill PV Sindhu, Sania Mirza, Sakshi Malik ….