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Epilepsy Awareness The Road To Choice

Epilepsy is a central nervous system disorder characterized by abnormal brain activity, causing seizures or periods of unusual behaviour, sensations and sometimes loss of awareness. It is one of the most common neurological diseases globally.

Epilepsy is a chronic non- communicable disease of the brain that can affect males or females of all races, ethnic backgrounds and races. Seizures are a brief episodes of involuntary movement that may involve a part of the body or the entire body.

Seizures can be classified into two main groups:
Generalized & Focal Seizures

1. GENERALIZED SEIZURES affect both sides of the brain and can further have 2 sub-types:
Absence Seizures or Petit Mal Seizures cause rapid blinking or staring into space for a few seconds.
Atonic Seizures or Drop Seizures cause a loss of muscle control especially the legs causing you to suddenly collapse or fall down.
Tonic-colonic seizures or Grand Mal Seizures cause a person to cry out, make them unconscious abruptly, fall to the ground or even have muscle jerks or spasms.

2. FOCAL SEIZURES or PARTIAL SEIZURES can affect just one area of the brain.
Simple focal seizures cause twitching or a change in sensation by affecting a small part of the brain.
Complex focal seizures can cause confusion or daze making a person unable to think and react properly for up to a few minutes.
Secondary generalized seizures begin affecting one part of the brain, spreading to both sides later on. In other words, a focal seizure developing into a generalized seizure.

How Common is Epilepsy?
1. As per World Health Organization (WHO), around 50 million people worldwide have epilepsy.
2. A study published in the journal EPILEPSIA “Prevalence and pattern of epilepsy in India”, predicts that there are more than 10 million persons with epilepsy (PWE) in India with a prevalence of about 1% in Indian population.
3. Just about 80% of people with this condition live in low- and middle-income countries.
4. Around 75% PWE living in low-income countries do not receive suitable treatment.
5. An appropriate diagnosis and treatment can help about 70% PWE lead a seizure free life.
6. PWE are at a three times higher risk of premature death than the general population.
7. PWE and their families face a lot of stigma and discrimination around the world.
8. WHO says that around 25% epilepsy cases are preventable.

Epilepsy Management
Treatment of epilepsy includes anti-seizure medications, special diets (typically in addition with anti-seizure medications) and surgery.

1. Medications: Certain medicines called Anti-seizure drugs (anti-epileptic medicine) are accessible which limit the spread of seizures in the brain. The success rate of anti-seizure medicines is about 2 in 3 people with epilepsy. A combination of these medications can help decrease the frequency and intensity of seizures.

2. Surgery: Epilepsy surgery is a treatment method of choice in people with focal seizures, mostly when the seizure focus is located in the temporal lobe of the brain and secondly when doesn’t interfere with vital functions such as speech, language, motor function, vision or hearing. Surgery either help to stop future seizures or make them easier to control with medicine.

3. Diet: Some people with epilepsy especially children, have been able to reduce their seizures by following a strict diet regime namely Ketogenic Diet, which is high in fats and low in carbohydrates. It can be a challenge and must be done under medical supervision.

SEIZURE FIRST AID
Apart from the above management techniques, there are certain steps involved in Epilepsy Seizure First Aid to help someone having a seizure.

Step 1: Create a Safe Space: Keep the person safe from harm. Move away any hard objects from the area to protect them from injury.
Step 2: Cushion Head: Put something soft and small under their head.
Step 3: Turn Person on Side if they are not awake and aware or if they have food, fluid or vomit in their mouth.
Step 4: Keep Airway Clear: Loosen tight clothes around neck and keep the airway clear.
Step 5: Time Seizure: Check the time and call an ambulance if the seizure lasts for a longer than 5 minutes or if the person doesn’t return to their usual state.

We recommend staying with the person until seizure ends and comfort them when they regain consciousness. Do not put any objects in their mouth and give rescue medicines only if prescribed by a health care professional.

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Common Wound Care Issues

Advanced Wound Care for the Elderly: Addressing Unique Challenges and Solutions

World Health Day reminds us of the importance of addressing health concerns across all age groups, particularly for the elderly. As people age, they often face unique challenges, including skin fragility and reduced mobility, which make wound care a crucial aspect of their health management. Advanced wound care tailored to elderly needs ensures better healing outcomes and improved quality of life.

Common Wound Issues in Elderly Patients

Skin Fragility & Chronic Wounds

Aging skin becomes thinner, less elastic, and more prone to damage. Studies indicate that skin tears affect up to 20-25% of elderly patients in long-term care facilities globally, highlighting the need for specialized wound management.  Source

Elderly individuals are particularly susceptible to:

  • Tears: Even minor trauma can cause significant skin injuries.
  • Pressure Sores: Prolonged immobility leads to pressure ulcers, especially in bedridden patients. A study in India reported that pressure ulcers affect nearly 8.3% of hospitalized elderly patients. Source
  • Diabetic Ulcers: Poor circulation and nerve damage increase the risk of chronic wounds, with diabetic foot ulcers affecting nearly 25% of diabetes patients in India at some point in their lives. Source
Limited Mobility & Circulation

Reduced physical activity affects blood flow, leading to slower wound healing. A study published in the Indian Journal of Plastic Surgery found that elderly patients with limited mobility take 30-50% longer to heal from wounds. Mobility limitations can also make it challenging to provide adequate care, increasing the risk of infections and complications.  Source

Specialized Dressings for Effective Care

1. Moisture-Retentive and Antimicrobial Dressings

These dressings maintain an optimal healing environment while preventing infections. Products like Velvert® Secure provide antimicrobial protection and promote faster recovery.

2. Non-Adhesive & Waterproof Options

Delicate aging skin requires gentle care. Non-adhesive dressings minimize trauma during changes, while waterproof options allow patients to maintain daily hygiene without compromising wound protection.

Orthopedic Support Products for Recovery

1. Compression Bandages/Stockings

For conditions like venous leg ulcers or swelling, compression products improve circulation and reduce edema, facilitating better healing.

2. Support Braces & Pads

Braces and padding prevent pressure sores and provide stability, especially for patients with mobility challenges.

Tips for Caregivers in Elderly Wound Management

  • Daily Monitoring: Regularly inspect wounds for changes or signs of infection.
  • Hydration, Nutrition & Hygiene: Ensure patients stay hydrated, eat a balanced diet, and maintain clean skin to support healing.
  • Gentle Mobility: Encourage safe physical activity to improve circulation and prevent stiffness.
  • Collaborate with Professionals: Work closely with healthcare providers to develop and follow a tailored care plan.

Advanced wound care plays a vital role in elderly health and well-being. By addressing their unique challenges with specialized solutions and caregiver support, we can improve healing outcomes and enhance their quality of life.

In this World Health Month, let’s advocate for proactive care and ensure our elderly population receives the attention they deserve.

Managing Chronic Wounds

Choosing the Right Dressing for Chronic Wounds

Chronic wounds, such as diabetic ulcers, pressure sores, and venous leg ulcers, present unique challenges in wound care management. These wounds often resist healing due to underlying conditions such as poor circulation, increased infection risks, prolonged or excessive inflammation, and other patient-specific factors.

Selecting appropriate dressings tailored to the needs of chronic wounds is essential to promote healing and prevent complications.

Chronic wounds develop due to systemic issues that delay natural healing. Common types include:

  • Diabetic Ulcers: These ulcers result from reduced blood flow and nerve damage, often occurring on the feet. Proper care involves maintaining a balance between moisture and dryness, ensuring the wound does not become too dry or overly moist.
Stat Spotlight

In India, diabetic foot ulcers account for approximately 20% of all diabetes‑related hospitalizations. ~ Source
  • Pressure Sores: Caused by prolonged pressure on the skin, these wounds are common among bedridden or immobile patients. Managing pressure and ensuring the wound stays clean and protected are vital.
Stat Spotlight

In India, point‑prevalence studies report that approximately 5% of hospitalized patients have pressure ulcers, underscoring the importance of preventive care. ~Source
  • Venous Leg Ulcers: These ulcers result from chronic venous insufficiency, in which impaired venous return causes fluid to accumulate in the lower legs, increasing tissue pressure and leading to skin breakdown. Effective management typically centers on graduated compression therapy to improve circulation, alongside advanced dressings to control exudate, leg elevation, and skin care to protect the periwound area.

Managing these wounds involves addressing infection risks, ensuring patient comfort, and promoting effective healing using evidence-based dressing solutions. Selecting the appropriate dressing depends on the type of wound, its condition, and the specific challenges it presents.

Below are some general guidelines:

Diabetic Ulcers

Dressings should maintain moisture balance and provide effective infection control. Non-adhesive dressings are preferred to minimize skin damage during dressing changes. Velvert®, with its strong antimicrobial properties and excellent moisture management, is ideal for diabetic ulcers and wounds at high risk of infection.

Pressure Sores

These wounds require dressings that redistribute pressure and effectively manage exudate to prevent further tissue damage and support healing. Velfix®-S offers both cushioning and absorption, making it a reliable choice for pressure sores and wounds requiring enhanced comfort and protection.

Venous Leg Ulcers

Advanced dressings used in combination with compression therapy are essential for managing exudate and improving circulation. Velfour®, with its high absorption capacity, is well-suited for heavily exuding wounds, including venous leg ulcers.

Infected Wounds

Antimicrobial dressings are effective in managing bacterial growth and reducing the risk of complications. Silvel™ with its strong silver based antimicrobial action and Velvert™ with their strong silver-based antimicrobial action, are suitable for infected or high-risk wounds such as second-degree burns, necrotizing fasciitis, and traumatic wounds.

Here are some types of advanced dressings that address specific wound care needs:

Antimicrobial Dressings

Designed to manage infection risks, these dressings often contain agents like silver to inhibit bacterial growth. Silvel™ and Velvert™ are widely used for diabetic ulcers and pressure sores prone to infection, owing to their strong antimicrobial properties.

Foam Dressings

Highly absorbent, these dressings are ideal for wounds with significant exudate, such as venous leg ulcers. They also offer cushioning to enhance patient comfort. Velsap™ and Velfix®-S are designed for moderate to heavily exuding wounds, ensuring effective fluid management and reduced dressing change frequency.

Multi-Layer Dressings

These dressings provide both absorption and protection, making them effective for managing pressure sores and heavily exuding wounds. Velfour® is an excellent example, offering essential support for such wound types.

Real-Life Example

A 60-year-old diabetic patient in India developed a non-healing foot ulcer. Initially, traditional gauze dressings were used, leading to frequent infections. After switching to Velvert™ antimicrobial dressing, the wound showed significant improvement within four weeks, with reduced exudate and no further infections. This case highlights the importance of selecting the right dressing for chronic wounds.

Practical Tips for Managing Chronic Wounds

Effective wound care goes beyond dressing selection. Here are additional strategies to optimize healing:

  • Proper Cleaning and Debridement: Regularly cleaning the wound and removing dead tissue helps create an optimal environment for healing.
  • Adjunctive Therapies: Techniques like compression therapy for venous ulcers and offloading for diabetic foot ulcers can significantly improve outcomes.
  • Regular Monitoring: Chronic wounds require consistent evaluation to identify changes in size, depth, or signs of infection, allowing timely adjustments in care.
  • Consulting Professionals: Work with healthcare providers to ensure the care plan addresses the wound’s unique needs and aligns with the patient’s overall health condition.

Selecting the right dressing for chronic wounds can significantly improve healing outcomes and enhance patient comfort. By understanding wound characteristics and tailoring treatments accordingly, healthcare professionals can address even the most challenging cases effectively.

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