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She sells sea shells by the sea shore
And the shells she sells are seashore shells I'm sure.

Dengue viral fever is a common viral infection in South East Asia and in Pakistan. In recent months it has made news because of rise in number of cases as well as in severity.

What is dengue?
The hemorrhagic fever occurring all over Pakistan is most commonly due to a virus called “Dengue” (Pronounced as “Dengy”).

How does it spread?
The virus is transmitted by the bite of a mosquito, which is different from the mosquito that causes malaria. The mosquito lays its eggs in clear water containers, house plants in water, and wherever water accumulates inside the house or in the premises. Therefore, the best way to eliminate this mosquito is to eliminate its breeding places inside and outside the house.

What are the sign and symptoms of this illness?
Infection with dengue usually produces a mild infection with fever and headache that may last 2 – 5 days with complete recovery.

Or it may present as “Classic Dengue”, with high fever and body pain with rash that may last 6 – 10 days and end with complete recovery.

A few patients may develop rashes on the skin, bleeding from gums or nose or in the vomitus or stool due to internal bleeding. This is the stage of “Dengue viral hemorrhagic fever”. This is a warning sign to contact your doctor immediately. Most patient recover with supportive care.

Rarely some patient with Dengue fever may go into shock (Dengue Shock Syndrome, DSS) with severe bleeding from different body sites, sudden fall in blood pressure, cool clammy skin and extreme weakness. Immediate and intensive care is life saving.

What laboratory tests are there?
In all cases of Dengue fever the blood platelet count (cells that help in clotting blood) decreases progressively, depending upon the severity of the disease. So, it is important to monitor platelet count regularly. Dengue can be confirmed by a specific blood test, which usually becomes positive after the first 5 days of fever.

Treatment
In all cases, fever should be controlled and plenty of fluids given, preferably by mouth or intravenous if unable to do so. Dengue Shock Syndrome is always serious, and any patient with bleeding should be hospitalized. There is no specific treatment but fluid and blood or blood products may have to be replaced urgently. Antibiotics, anti-malarials and antiviral medications have no role in this infection.


How to prevent the spread of dengue?
Dengue is not spread from person to person; therefore, the patient need not to be strictly isolated. Only normal precautions to avoid touching blood must be observed.

Spraying garbage with insecticide will not eliminate mosquitoes entirely. Keep all water storage tanks and containers covered. Do not let clean water collect in kitchen, bathroom, utensils, drums, etc for more than 3 days.

Dengue infection is here to stay and will increase in number and severity unless we eliminate breeding places for mosquitoes.

this post will be for those who can not remember.... relations more then things.

Try spending a morning imaginig that you are such a carer - eg trying to expunge the smell of soiled sheets from your clothes, while awaiting a visit from a neighbour, who said he would 'sit with him' so you can catch the bus into town, and, like a guilty hedonist, play traunt from your role as a nurse for a few sanity-giving hours of normal life. You wait. No one comes. You stop bothering about the smell on your clothes, and turn towards your husbad, about to say something, but when your eyes meet his, you realize he does not recognize you -- and you keep your thoughts to yourself. Knuckles whitten as you grasp his collar to lift him forward on the commode, and you seem to hear a mocking voice over your shoulder say: '...so I see we're getting angry with him today, are we?" The ceaseless round from mouth to anus, from bed to chair, from twilight to twilight, continues, ad finitum.

International Day of Quds is an annual occasion to commemorate the perceived occupation of Quds (Jerusalem)
by Israel. Anti-Israel demonstrations are held on this day in some Muslim countries or by Muslim or Arab communities around the world, but especially in Iran, where the occasion was first suggested. It is held each Islamic year on the last Friday in Ramadan.

The observance was suggested by Ayatollah Khomeini, the late Supreme Leader of Iran in August 1979. He quoted

"I invite Muslims all over the globe to consecrate the last Friday of the holy month of Ramadan as 'Quds Day' and to proclaim the international solidarity of Muslims in support of the legitimate rights of the Muslim people of Palestine." "For many years, I have been notifying the Muslims of the danger posed by the usurper Israel which today has intensified its savage attacks against the Palestinian brothers and sisters, and which, in the south of Lebanon in particular, is continually bombing Palestinian homes in the hope of crushing the Palestinian struggle. I ask all the Muslims of the world and the Muslim governments to join together to sever the hand of this usurper and its supporters. I call on all the Muslims of the world to select as Quds Day the last Friday in the holy month of Ramadan - which is itself a determining period and can also be the determiner of the Palestinian people’s fate - and through a ceremony demonstrating the solidarity of Muslims world-wide, announce their support for the legitimate rights of the Muslim people. I ask God Almighty for the victory of the Muslims over the infidels. "