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What Is Malaria? Plasmodium parasite is the causative agent of  malaria. It is transmitted to humans by the bite of an infected Anopheles mosquito. As per the latest report of ICMR or Indian Council of Medical Research published in December 2021, India saw about 4.2 million malaria-affected patients and around 7400 deaths. Thus, in South-East Asia, specified by WHO or World Health Organisation, India contributed to almost 82% of malaria cases and deaths. Causes of Malaria When a female Anopheles mosquito feeds on someone who already has malaria, it gets infected. The next time it bites you, it may transfer the single-celled malaria parasite, Plasmodium, into your body. These parasites, on entering your body, travel down to the liver. Certain types of this parasite may lie dormant in the body for over a year. Then, these parasites mature and leave the liver while infecting the body's red blood cells, and you start developing the symptoms of malaria.  After you get infected with malaria, when uninfected malaria bites you during this transmission cycle, it will also get infected with the malaria parasites in your body. This way, it will keep spreading the disease to whoever it bites.  When these parasites affect your red blood cells, other people may get exposed to the infected blood can and catch malaria. These transmissions can occur between a mother and unborn child, sharing needles for injection, blood transfusion, etc.  Malaria Symptoms The signs and symptoms of malaria usually start appearing within six  to fifteen days  after you get infected. The symptoms can be mild or severe, depending on the parasite type. Sometimes, people don't show any signs or feel sick for a year after being infected with the mosquito bite. This happens when the parasites live in your body for more than a year without causing any symptoms.  Common signs of malaria are: Very high fever and sweating Chills  Muscle ache and headache Fatigue Chest pain, difficulty in breathing, cough Nausea, diarrhoea, vomiting  Severe signs and symptoms of malaria include Jaundice and anaemia Convulsions Stools with blood Seizure Kidney failure Abnormal and sudden reduction in blood sugar level Dark urine Trouble in breathing Confusion  Types of Malaria Parasite Maria can be of five types depending on the types of plasmodium parasite that has caused infection. Plasmodium vivax Plasmodium ovale Plasmodium malariae Plasmodium falciparum Plasmodium knowlesi Among these five, plasmodium vivax and plasmodium falciparum are common in India. The latter multiplies rapidly, leading to excessive blood loss, clogging the blood vessels, leading ischaemic damage of organs.  On the other hand, Plasmodium vivax can stay dormant for many months or even years after the mosquito bite. But suddenly, it rises and starts to infect the blood, showing the symptoms mentioned above. Diagnosing Malaria Once you start to feel sick, visit the doctor as soon as possible. Your physician can examine you and ask for a blood test to detect the presence of a parasite. Also, inform them about your travel history to help them better understand your health risks. The blood tests help the doctor to  diagnose malaria, find the type of plasmodium causing infection and the treatment course. The Blood Tests Can be of Different Types: Peripheral  blood smear examination: Thick and thin blood smears are prepared from patients' blood, stained and observed under a microscope. Malarial parasites can be detected and speciated by this test. This is considered the gold standard test for diagnosis of malaria.  Molecular test like PCR: If the blood smear report is not conclusive, doctors can ask for a molecular test to  detect the presence of a parasite. This test has the best sensitivity among all available tests for malaria. Rapid antigen test which detects parasite’s enzyme or antigen.  Malarial Antigen (Vivax & Falciparum) Detection test is easy to perform and can differentiate the two common types of plasmodium species Treatment  Treating malaria during the early stages will help you recover better. However, if left untreated for a long time, malaria can become life-threatening. Moreover, it can become even more severe if infected with the P. falciparum parasite. Therefore, doctors prescribe antimalarial drugs, such as: Hydroxychloroquine or Chloroquine – This medication is effective if the malaria symptoms are not severe. Atovaquone-proguanil – This combination is more suitable for treating malaria in children or people in areas where chloroquine does not work. Artemisinin-based therapy – Here, doctors combine two different medicines to fight the milder symptoms. Artesunate – In case of severe symptoms, health experts give artesunate for the first day and then follow artemisinin-based therapy for three days. Nevertheless, in certain instances, the prescribed medicine may not help to clear the infection due to the parasite's resistance to the drugs. This is when your doctor either changes your medication or prescribes more than one medicine to treat your case based on the signs of malaria.  Apart from medications, other treatments include: Supportive care Hospitalisation Intensive care for severe malaria This treatment period may last for about two-three days. The medications or treatment length depends upon factors like: The types of malaria and their symptoms The severity of the symptoms Antimalarial drug history of the person For pregnant women In most cases, malaria is cured and does not lead to severe consequences if you go to your doctor at the right time. So, keep the symptoms of malaria in mind, and visit your doctor at once. If any of them show, get all the tests done to start your treatment. And also, sleep under mosquito nets, wear proper clothing and use mosquito-eliminating sprays to stay away from mosquito bites. 

Several blood-borne infections can pass on from one individual to the other irrespective of the fact that person may not have any symptoms. This is because Hepatitis C Virus or HCV may not exhibit symptoms even at an acute stage. No wonder, then, that it is also often referred to as a silent epidemic. About Hepatitis C (HCV) Infection HCV infection is caused by Hepatitis C Virus (HCV), resulting in swelling and damage to the liver. Such is the silent nature of the disease that one in two individuals with HCV infection may not experience symptoms for decades after contracting HCV. Without HCV treatment, the chances of the spread more than double.  HCV infection progresses through different stages. The period between HCV entering the body and the start of the Hepatitis C disease is called the incubation stage. The next stage lasts for about six months and is termed Acute infection. Few patients with acute Hepatitis C may get rid of the HCV infection without moving to the chronic stage. Over 85 percent of patients in the acute phase may enter the chronic stage, leading to severe conditions such as cirrhosis or liver cancer.   Early diagnosis and medication are known to be effective in curing the infection. Hence, HCV screening is advisable for people at high risk How Can You Get an HCV infection? The Hepatitis C Virus enters your body through infected syringes and blood transfusion. Sharing personal items like toothbrushes, shaving razors, or nail clippers will make you more likely to contract the disease but this is rare. In addition, individuals with multiple sex partners can get HCV if they are not taking precautions like using condoms. An infected person's partner is equally at risk of being infected with the Hep C virus. What are the Hepatitis C (HCV) Symptoms? As mentioned earlier, you may not exhibit any HCV symptoms despite an active Hepatitis C infection. It may take two weeks to six months for the initial symptoms to surface. In certain cases, though, symptoms remain mysteriously absent even at the stage where the infection has turned chronic. It is only when HCV begins to damage the liver that you experience severe symptoms. An acute HCV infection comes with the following symptoms: Nausea and vomiting Pain in the abdomen Appetite loss Yellowing of skin, eyes, and urine Poop having clay colour Fever Weakness Symptoms of chronic HCV infection are more serious. Chronic HCV infection causes scarring of liver tissues and may lead to cancer. Why is HCV Screening Crucial? Chronic HCV infection can damage the liver and patients may end up with terminal illnesses like liver cirrhosis or cancer. HCV testing involves  detection of HCV antibody Simple and quick test- HCV screening involves a simple blood test to determine if you have the infection. In addition, the physician may recommend a repeat test to rule out the probability of a chronic infection. High-risk individuals should consider a repeat HCV test even if the first test was negative as HCV antibody take some time to rise after exposure Confirmation through PCR If you have a positive HCV antibody test it is advisable to get a HCV PCR test done to confirm diagnosis.The PCR test involves the detection of RNA, a type of genetic material. A quantitative  HCV RNA PCR test measures the viral load in patients who test positive for the anti-HCV screening test. It is also helpful in assessing the effectiveness of the antiviral treatment for HCV infection. Visit us for HCV RNA Detection Test.

Overview: Typhidot Test The Typhidot test is a rapid serological test that assists medical professionals in diagnosing typhoid fever. A bacterium called Salmonella Typhi causes this fever. When this bacterium enters your body, your immune system releases two types of antibodies, IgG and IgM, to fight against the bacteria. Typhidot test is a ready-to-use dot ELISA kit designed for qualitative detection and differentiation of these antibodies separately against the outer membrane protein (OMP) of the Salmonella Typhi bacterium. Typhoid is one of the most prevalent diseases in Indian settings. The fever spreads through contaminated food, drinks, and drinking water. It is a life-threatening illness that needs rapid diagnosis to ensure appropriate treatment of potential carriers and prevent Typhoid outbreaks.  Most of the detection methods fail to show accurate results. To confirm the presence of the bacteria, many patients are required to undergo ELISAs (enzyme-linked immunosorbent assays) and other blood cultures several times. Another diagnostic measure is bone marrow culture. But, it is too invasive and cannot be performed in a laboratory setting. In this respect, the typhidot test has proved to be an extremely valuable diagnostic tool.  What is the Typhidot test used for? Doctors routinely order a Typhidot test to evaluate people who exhibit the following symptoms: Fever with body pain, especially in the head and legs Increased weakness and sleepiness Gradual increase in body temperature Bloating sensation  Stomach pain Diarrhea  Loss of appetite Cough Slow pulse rate in comparison to increasing body temperature Gastroenteritis (inflammation of intestines)  The appearance of small red boils or rash on the back or in the abdominal area after a week of fever Malaise (a feeling of discomfort, weakness, loss of interest in any activities) In some extreme cases, typhoid fever may also be accompanied by: Abnormal heart rate Excessive sweating  Intestinal hemorrhage  Enlarged liver and spleen Distended abdomen (abnormally swollen abdomen) When should you contact a doctor? Get in touch with a doctor if you have any of the following: Have visited an area where people are suffering from typhoid fever, and you have developed the symptoms  Have been exposed to a person who has typhoid fever Have symptoms like reduced urine output, severe abdominal pain, and any other new symptoms Have suffered a recurrence of typhoid fever symptoms What happens if typhoid fever is left undiagnosed? Complete recovery from typhoid fever depends greatly on timely detection with the Typhidot test and accurate treatment. Delay in the same can lead to serious health complications. They can be: Kidney failure: Typhoid fever can cause acute renal failure and hepatitis, although these conditions are rare.  Internal bleeding: If typhoid fever is not treated with appropriate antibiotics, it can cause internal bleeding. If the condition worsens, the patient may require a blood transfusion. Peritonitis: It is a very serious complication in which the bacteria infects your peritoneum (lining of your abdomen). How do you prepare for a Typhidot IgM test? There are no specific precautions or preparatory steps before this test. But remember to inform the doctor about any medications or health supplements that you take regularly. You may be asked to stop the intake for a few days before the test. Further, if you have any underlying medical condition, inform the doctor and the lab technician. Also, you do not need to fast before a Typhidot test.  What is the procedure of the Typhidot test? A Typhidot IgM test is conducted in the following steps: An elastic band or tourniquet is tied firmly to your upper arm. You are asked to make a tight fist. As a result, the veins fill with blood, making it easier to collect the blood. Once the vein is located, the spot is cleaned using an antiseptic liquid. It stops any bacteria from entering your body. The needle is inserted into the vein, and the blood sample is collected in a vacutainer tube.  The lab technician takes out the needle and releases the elastic band. You can then open your fist. A gauze pad or cotton is used to stop the bleeding. After this, the blood sample is placed on the Typhidot test kit and combined with the chemicals or reagents provided with the test kit.  The test kit shows results within 1-3 hours. Things to consider after a Typhidot test is complete After the Typhidot test is completed, the needle is taken out gently. The needle insertion site is covered with cotton to stop the bleeding, and a bandage is applied. Initially, you may feel some pain, but it subsides in a few days.  There are no post-test restrictions associated with aTyphidot IgM test. You can resume your routine activities, eat, drink and move around. However, after receiving your test results, you must schedule an appointment with a doctor to discuss and understand if there are any concerns.  What precautions should be taken when collecting samples for Typhidot tests? Some precautions must be kept in mind while handling the test kit and the blood sample. They are:   The test device must be kept sealed until used. It must be stored at 4–30°C. It must be kept safe from heat, moisture, and sunlight. All standard measures must be followed during sample collection. All the samples or specimens must be handled with extreme care as they are potentially infectious. If the sample cannot be tested immediately, it must be refrigerated at 2–8°C. If the storage period is longer than three days, the specimens must be stored at –20°C. How much does a Typhidot test cost? The Typhidot test price may differ from city to city. Let us look at the average Typhidot test price in a few major cities: Mumbai — ₹581 Delhi — ₹447 Pune — ₹662 Hyderabad — ₹588 Kolkata — ₹602 Lucknow — ₹490 Gurugram — ₹422 Srinagar — ₹385 Surat — ₹535 Chennai — ₹419 The price of the Typhidot IgM test can vary depending on the lab partner, location, and timing.  When should you expect the results of the Typhidot test? The turn-around time of the Typhidot IgM test is one of the key features. You can expect the results within a few hours. Then, the results are compared to the range or readings provided with the kit.  How do you interpret the results of the Typhidot IgM test? The Typhidot IgM test is an enzyme immunoassay used to detect the IgM and IgG antibodies produced by your body’s immune system against the Salmonella Typhi bacteria with a 50 kilodaltons outer membrane protein. The test isolates the IgG and IgM antibodies with the help of nitrocellulose strips infused with the OMP antigen. Negative results on the test kit indicate the absence of infection. However, Typhidot IgM positive means or points towards a recent infection. Also, if your test results show IgG positive, it indicates a past or chronic infection. For an accurate understanding of the test results, you must visit a doctor. After analyzing the results, the doctor can prescribe a proper course of treatment.  What are the advantages of the Typhidot test? The Typhidot IgM test offers several advantages, which make it very convenient for clinical use: Provides early and specific diagnosis of typhoid fever Easy to conduct Rapid and reliable  Only a blood sample is required; no other specimen is needed The test does not require any special equipment or apparatus The quantity of blood samples needed is minimal Test results are easy to interpret Typhidot test price is affordable Is the Typhidot test definitive and reliable? Most doctors and healthcare consultants generally use the Typhidot test in the diagnosis of typhoid. They find it an easy-to-use, quick, and a promising option for the timely diagnosis of this health condition. Further, it is safe for all age groups.  Are there any risks associated with the Typhidot test? A blood sample has very little risk associated with it. In some people, locating veins and arteries can be a challenge, due to which taking blood samples can be difficult. Apart from this, the below-mentioned may occur: Hematoma (accumulation of blood under your skin) Swelling in the particular vein from where the blood sample was taken Excessive bleeding Fainting or lightheadedness Infection at the needle insertion site Before the test, remember to inform the lab technician if you suffer from any bleeding disorder, take any blood-thinning medications, or have fainted during a blood test in the past. It is important to note that the above issues occur very rarely and generally resolve themselves. Overall, the Typhidot test has no significant risks. In case of dizziness after a blood test, what should you do? In case you feel dizzy or nauseated, drink plenty of fluids and take sufficient rest. Avoid intense workouts for the next 2-3 days, and do not lift heavy objects. Ensure that a family member or friend is there to look after you. If the dizziness continues, contact your doctor without any delay. Are there any limitations to the Typhidot IgM test? The most significant limitation of the Typhidot IgM test is that it is not quantitative, which means the results show either positive or negative.  Quick tips to stay protected from typhoid fever Washing your hands frequently with soap and water is the best way to keep typhoid infection at bay. Be extremely cautious in the matter of drinking water. If possible, boil it before consuming it. Avoid raw milk. Drink only boiled milk. Preferably eat food that is hot and fresh. Avoid food items that are stored and served at room temperature. Do not eat food from street vendors. It is better to eat cooked food. Keep the number of raw fruits and vegetables in your diet low.  Get vaccinated. Conclusion  Typhoid is widely recognized as a grave health concern in our country. Further, with the emergence of new strains of bacteria, this health condition can be significantly damaging. Hence, the importance of early diagnosis is undeniable. Typhidot IgM is an advanced diagnostic tool to detect the disease accurately and treat it promptly.

The disease is prevalent in subtropical and tropical countries like India, Vietnam, and Africa, where mosquito control is a big challenge. Once the infected mosquito bites the host human or animal, it injects the parasite into the host’s bloodstream. The parasite travels to the host’s liver, which becomes its breeding ground, where it matures. And gradually the body starts showing malaria symptoms. You can detect malaria through a simple blood test, which is essential to deciding the course of treatment. Recovery might be slow, and quarantine is advised.  Signs and Symptoms of Malaria The signs and symptoms of malaria may vary from animals to humans. In humans, too, it varies in severity from young to old. The manifestation of malaria may occur within 610 to 15 days of exposure and sometimes as late as six months. The most common malaria symptoms include: Fever Shivering or chills A constant uneasy feeling Diarrhoea Headaches Rapid heart rate Increased breathing Underlying fatigue Muscle pain Joint pain Nausea and vomiting Pain in the abdomen Dry cough Malaria may manifest in some adults through intense bouts of chills and fevers, which may last for a few minutes or hours. This is quickly followed by extreme sweating when the fever subsides. In medical terms, this is a classic malaria symptom, also known as paroxysm. Such cyclic manifestation may not be seen in all patients. In children, the symptoms are mostly restricted to high fever, dry caught, diarrhoea, and vomiting.  Initial Signs of Malaria In the early days of exposure, you may feel that the signs and symptoms of malaria are similar to other conditions like a viral infection, gastroenteritis, or sepsis. The symptoms may include: Headache High fever Joint pain Vomiting Hemolytic anaemia Jaundice Blood in the urine Convulsions Types of Malaria and their Symptoms According to the World Health Organisation (WHO), you can classify malaria as severe or uncomplicated. It is declared severe if one or more of the following malaria symptoms appear: Inability to eat Very low blood pressure (<70 in adults and <50 in children) Decreased consciousness Difficulty in breathing Pulmonary oedema Haemoglobin <50g/L Circulatory shock Lactate levels >5 mmol/L Parasite level in the blood >100K/μL In extremely severe cases, the patient may present neurological symptoms, including coma. Such cases are called cerebral malaria. Causes of Malaria Malaria is caused by a single-celled parasite of the plasmodium group. As discussed, the parasite is injected through a mosquito bite in humans and animals. The following steps explain the cycle of parasite transmission that causes malaria. The female Anopheles mosquito bites an infected host and becomes infected with the parasite. This mosquito then bites another host, transmitting the parasite into the host’s body. The parasite enters the bloodstream and travels to the liver, which becomes its breeding ground to mature and reproduce for about a year. Once the parasites mature, they leave the liver and attack the red blood cells. Once in the red blood cells, the parasite begins to affect the host’s immunity, which manifests the signs and symptoms of malaria.  The entire cycle is repeated if an uninfected mosquito bites this infected person at this juncture.  Other Ways of Malaria Transmission There are a few other ways in which you can contract malaria. The infection can be transmitted: From a pregnant mother to an unborn child Through blood transfusions Sharing used needles Living or visiting an area or region where the disease is prevalent also increases your chances of contracting malaria. The most popular regions in the world that are notoriously famous for the prevalence of malaria are: Southeast Asia South Asia Pacific Islands Central America Northern South America Sub-Saharan Africa While there are preventive measures in place that the local governments ensure, the inherent climate is a potent factor in the spread of the disease. Those who are at a greater risk of contracting malaria are: Infants Young children Older adults Pregnant women People travelling from areas with no prevalence of malaria Recurrent Malaria Malaria symptoms can come back even after a prolonged period of non-recurrence. Based on the cause, recurrent malaria may be classified into three types. Types of Recurrent Malaria and their Symptoms Recrudescence Malaria: Often, the parasite may survive in the blood due to ineffective or inadequate treatment. The patient may experience a long symptom-free period post the first occurrence. And the disease may still come back after a while. Relapse: Sometimes, the parasites may have been effectively eliminated from the body through the proper treatment. But remnants may have survived as dormant hypnozoites in the liver cells. A relapse will typically occur within 2 weeks to 10 months 8 to 24 weeks of the first occurrence of malaria. Reinfection: As the name suggests, reinfection simply means that the host gets reinfected with a new malaria parasite. This may happen even after the earlier parasite is eliminated from the body.  Diagnosis of Malaria The nature of malaria symptoms is non-specific. This makes it difficult for any particular test to pinpoint the result. The diagnosis is primarily based on initial signs and symptoms of malaria, which are then confirmed with the help of a parasitological test. The diagnosis is relatively more straightforward in regions where malaria is high. In fact, according to WHO protocol, any person presenting symptoms of fevers and chills will be first quarantined for malaria. Other factors that are considered for diagnosing malaria include: Children with any signs of anaemia - pale palms or low haemoglobin Pregnant women with low blood pressure In regions with a prevalence of malaria, WHO has recommendations and guidelines for diagnosing the disease. Only those with possible exposure to malaria-prone areas or any unexplained fever need to be tested.  Test Procedure for Detecting Malaria A microscopic examination of blood films or an antigen-based RDT (Rapid Diagnostic Test) is the standard procedure for confirming the presence of the malaria parasite in the blood. Microscopy is considered the gold standard test procedure for implementing this test. Here, Giemsa-stained blood is examined under a light microscope, and the presence of the parasite is confirmed or ruled out. The test is confirmed positive only when there is a minimum presence of apx. 5-10100 parasites per μL of blood. This is the minimum requirement to confirm symptomatic infection.  This procedure is resource-intensive and requires trained personnel and a proper laboratory setup. On the other hand rapid antigen tests are easy to do There may be places where microscopy is not the go-to for testing malaria. The resources might simply be unavailable. In such cases, a rapid antigen test may suffice to detect the presence of parasite proteins through a finger stick blood sample. At MHL through a careful selection of kits available in market both the important species of malaria are detected by this technique i.e., P. falciparum and P. vivaxThe HRP2 is the most common quick antigen test kit that is used for this kind of procedure.  Other tests like serological tests are still used to detect the presence of antibodies against the malaria virus. But they are insufficient to diagnose signs of malaria. Other options include the relatively expensive nucleic acid amplification test. But they are not common. Metropolis healthcare ltd. also offers cutting edge tests like comprehensive fever panel by multiplex PCR which can detect all species of malaria, salmonella (typhoid), chikungunya, dengue, leptospira, zika virus, west nile fever which may co-occur with malaria during the monsoon season. This test is done through blood sample and is of great help in diagnosing fever during monsoon season Treatment for Malaria You may be prescribed antimalarial medications depending on the type and severity of malaria. Common medicines are prescribed for the fever but are not enough to cure malaria.  Treating Uncomplicated Malaria Oral medications like artemisinin drugs are most effective for treating uncomplicated malaria. ACT or Artemisinin-Combination Therapy is the most popular way of treating this type of malaria and has proven to be 90% effective. Some deciding factors about the course of treatment for malaria include: Age of the patient Pregnancy Type of malaria Severity of the symptoms One must consult his doctor before taking any treatment for malaria. Common Medications for Treating Uncomplicated Malaria Listed below are some of the most common drugs prescribed by doctors to treat malaria symptoms - Chloroquine Phosphate: Chloroquine was the obvious choice for treating parasites until about a few years ago. But there are increased incidences of drug resistance, because of which it is no longer the most effective. ACT (Artemisinin-based Combination Therapies): ACT is the most effective and popular choice for treating the malaria parasite. It is also effective against the chloroquine-resistant malaria parasite.  Other common medications for treating signs of malaria include Malarone (atovaquone-proguanil), Primaquine Phosphate, etc. Treating Severe Malaria Best done in a critical care unit (CCU), the typical steps in this kind of treatment include: Managing a very high fever Monitoring laboured breathing Managing low blood sugar and potassium Typically, the quinine loading dose is administered to reduce the fever and slowly eliminate the parasite from the body.  Treating Cerebral Malaria Malaria with the worst neurological symptoms, including coma, is called cerebral malaria. Usually, clinicians and medical practitioners must determine the cause of the coma to determine the course of treatment. If this is unclear, the comatose condition may be attributed to other locally prevalent causes of encephalopathy. But if the case is registered in an area with a high malaria prevalence, the treatment for the same can be started immediately. The management of cerebral malaria follows a few standard steps : Monitor the vitals of the patient every two hours. Patients should not be left on a wet bed. The patient should be aided with a sterile urethral catheter to help in urination. A sterile nasogastric tube has to be inserted to aspirate the stomach. If convulsions occur, an IV injection of benzodiazepine must be administered.  A blood transfusion may be helpful in some cases.  Prevention of Malaria As with most other diseases, malaria is very much preventable. You can resort to easy and effective measures to prevent the contraction of the disease. A few simple ways to do this include: Cover your skin if you are in an area prone to malaria. Use a mosquito repellant or a mosquito net while sleeping (the Anopheles mosquito is most active between dusk and dawn). Use an apparel roll-on to repel mosquitoes. Don't let water accumulate in spaces like open drainage or sewage. Clear overgrowth from your neighbourhood.  If you belong to a place with little or no incidence of malaria, make sure to carry preventive medicine if you travel to a place with a high incidence.  You may also consult a doctor who can administer preventive malaria drugs before you travel to these places.  Malaria is very much preventable and curable. Along with the proper treatment and timely diagnosis, a little public awareness can also go a long way in tackling this deadly parasite with appropriate treatment and timely diagnosis. 

Introduction It is a misconception that mosquitoes thrive only in tropical, warm environments. They can also survive in temperate and colder regions during summer and spring. It is challenging to avoid mosquito bites. Here are some 15 tips to prevent mosquito bites while sleeping. Mosquito bites are frequent during the warm monsoon season, they also make their presence felt during winter. Mosquito bites cause red, itchy bumps on the skin and can even cause life-threatening diseases like dengue, malaria, chikungunya and zika. Therefore, knowing how to prevent mosquito bites effectively is vital.  1. Steer Clear of Mosquito Habitats Mosquitoes require still, stagnant water to lay their eggs. Young mosquitoes can hatch and grow in anything that holds even a small amount of water. Therefore, clearing stagnant water and trash is necessary, especially during monsoon season. Remove old tyres as they are considered prime mosquito nurseries. Drill holes in them to let water drain out. Do not pile up on cups, cans, empty bottles and other forms of trash. Discard trash responsibly. Empty children’s buckets and pools after use. Eliminate still water in plastic covers, gutters, toys and other containers that are great mosquito havens. Change and empty water in fountains, bird baths, rain barrels, wading pools and potted plant trays at least once during the week, thus destroying potential mosquito breeding grounds. Fill temporary water pools with dirt. Treat and circulate water in swimming pools. 2. Dress Wisely Deep-coloured clothing, like deep blue, red and black, stands out and attracts bugs. Therefore, wear light-coloured clothes, especially when you head outdoors. When mosquitoes are overly active in the evening, wear full-sleeve shirts, socks and long, preferably loose pants. Always tuck the pants under the socks or shoes so that no surface area on the body remains open. 3. Opt for Woven Clothing Breathable fabrics with tight weaves, like nylon, cotton, and denim, are difficult for mosquitoes to penetrate. On the other hand, they can easily bite through lighter and thinner fabrics like spandex. So, always choose tightly woven fabrics.  Also, choose clothes pretreated with the insecticide permethrin if you reside in a mosquito-prone region. Mosquitoes that land on this kind of clothing fly off and eventually die. 4. Use Mosquito Repellents You can use different mosquito repellent lotions, sprays and creams that effectively ward off mosquitoes. These are infused with chemicals and herbal oils that keep mosquitoes at bay with their fragrance. However, choosing the right repellent is very important here. AAP  or the American Academy of Paediatrics recommends DEET repellents that protect against West Nile virus, Zika virus and Lyme disease. Other effective mosquito repellents contain PMD, IR3535 insecticide or picaridin, which are considered safe when used as instructed. Check for skin irritations when choosing mosquito repellents, especially for children and pregnant women. Avoid spraying the content around the mouth and eyes. Use them on the feet, ankles, wrists and lower legs- these are the thin-skinned areas of the body where mosquitoes usually bite. 5.  Use Mosquito Nets How do we prevent mosquito bites while sleeping? By using mosquito nets! They are specifically useful in humid and warm places throughout the year and create a physical barrier that protects from mosquito bites while sleeping. Well-fitted screens on windows and doors are also good to keep mosquitoes away from entering your home or other premises. But then you must ensure they are repaired from time to time. Check for holes large enough for insects to come through. Patch up all such holes on your window or door screen. 6. Safeguard the Backyard Use a mosquito lantern with a permethrin release function in your backyard, especially if it is semi-enclosed or features a pool with two to three walls. Do not choose torches, lanterns and citronella candles, as even the slightest breeze can blow away the active ingredients in these products. You can depend on wind power to ward off mosquitoes from open areas surrounding your premises. Another option is to set up a big box fan in the yard. Once the air speed of the fan reaches more than 1 mile per hour, mosquitoes will find it challenging to fly. Also, fill up your home and garden with mosquito-repellent plants like citronella, feverfew and lavender. 7. Always Have Mosquito Dunks Handy Mosquito dunks are small, doughnut-shaped tablets that release bacteria known to kill mosquito larvae. The bacteria do not harm plants, animals and humans and are thus the perfect solution for homeowners who want to know how to prevent mosquito bites. These small dunks are also effective in potentially infected regions like rain barrels, fish ponds and bird baths. Therefore, you must always have them handy. 8. Stay Indoors During Dawn and Dusk Culex and Anopheles mosquitoes that cause dangerous infections are most prevalent during dusk and dawn, primarily dusk. Therefore, you must avoid the outdoors as much as possible during these times of the day. 9. Keep the Surrounding Landscape Clean Well-trimmed shrubs and trees improve the air circulation of a property. Increased airflow pushes the mosquitoes out of the area. 10. Use Bug Zappers Bug zappers or mosquito traps use UV light and carbon dioxide to attract and kill mosquitoes. Mosquitoes are attracted to the blue glow of these traps. Just one of these electronic mosquito killers from a good brand offers half an acre of coverage. 11. Burn Neem Leaves and Repellent Oils Looking for a budget-friendly way to prevent mosquito bites? Get some neem leaves from the backyard and burn them safely at the entrance of your house or other mosquito-prone areas. This effectively purifies the surroundings as mosquitoes cannot bear the smell of burning neem leaves. You can also use affordable repellent coils that burn for seven hours and release a smoke-containing pyrethroid. This serves as a spatial repellent for mosquitoes and even other insects. 12. Say No to Scented Products      Research has proved  that scented products, like lotions, shampoos, soaps, aromatic oils or perfumes, attract mosquitoes more. Thus, try to use such products less, or opt for products with a very light scent or no scent. 13. Use Yellow Lights in the Outdoors Replace outdoor illuminators with bright, yellow lights. These do not repel mosquitoes but usually attract fewer of them. 14. Limit Your Movement Activity and movement make you more apparent to the mosquitoes. When these bugs get closer to land, they sense body heat, indicating where blood is the closest to the surface. Hence, they know where to feed. More activity and movement will raise your skin temperature, thus making you stand out easily. 15. Avoid Alcohol      Studies show that consuming alcohol  also makes people attractive to mosquitoes. This is because alcohol increases the blood flow to the skin and the metabolic rate. The latter boosts CO2 production, which helps the mosquitoes find their food sources faster and make you the centre of their attacks. Conclusion Mosquito bites do not cause any harm and resolve themselves after a few hours. Nevertheless, they can be annoying, itchy and sore in their appearance. Follow the tips above to eliminate those red, swollen bumps on your skin faster and more effectively.

A Widal test meaning is a sersology blood test that helps detect typhoid or enteric fever in the body. This test was first conducted in 1896 by Georges Ferdinand Widal and was named after him.  The Widal test is an advanced way to check for antibodies that your body makes against the salmonella bacteria that causes typhoid fever. It looks for O and H antibodies in a patient’s sample blood (serum). This test helps detect life-threatening illnesses like typhoid fever. However, interpreting the Widal test is important to arrive at the correct results.  Keep reading this blog to understand the meaning of the Widal test, its principle, procedure, and test result interpretation. Typhoid Fever and Widal Test Typhoid fever, also known as enteric fever, is a severe illness caused by salmonella bacteria. This bacteria affects your digestive system after you consume food or water contaminated with faecal material.  A person with typhoid fever will experience symptoms like fatigue, high fever, headache, diarrhoea or constipation, abdominal pain, weight loss, and red spots. It is crucial to detect and treat typhoid fever as soon as possible to prevent further complications like severe intestinal bleeding or perforation. There are various tests available to detect typhoid fever, such as stool culture, bone marrow, etc. One such test is the Widal test, which detects the presence of antibodies that your body makes against salmonella bacteria during typhoid. The bacteria that causes typhoid fever is Salmonella bacteria. It can spread from person to person or from consuming contaminated food. The bacteria are of two types: Salmonella Typhi, also known as S. Typhi, Salmonella Paratyphi, which is also known as S. Paratyphi Now, the bacteria S. Typhi has two antigens named: S. Typhi O (TO), primary antigen S. Typhi H (TH), secondary antigen On the other hand, the bacteria S. Paratyphi has the following two antigens: S. Paratyphi A S. Paratyphi B  To understand and interpret the Widal test reports, we will discuss these values later in this blog to understand and interpret the Widal test reports. Principle of Widal Test When you consume food contaminated with salmonella bacteria, it enters your body in the form of antigens. After reaching your digestive system, your immunity creates antibodies against those antigens. As a result, antigens agglutinate (react), and typhoid fever is detected. This agglutination test detects the antibodies your body has made in response to a particular bacteria or antigen. If you have typhoid fever, your sera (blood) will possess antibodies that will react and agglutinate salmonella antigens in an agglutination test.  The main Widal test principle is that if a particular antibody is present in the serum, it will react with a specific antigen and show visible clumping on the test card.  The following step of this test measures the titre of the positive antigen: Preparation of Widal Test Slide Widal Test To prepare for a Widal test, we would require the following objects: Patient’s serum Pipette (lab tool) Serum S. Antigen ( O, H, AH, BH) Slide Mix Stick Stopwatch You will also need reagents to detect antigens like O Ag (somatic or surface Ag), H Ag (flagella), AH Ag, BH Ag, etc.  The Widal test procedure is carried out in two steps: Qualitative Widal Test For this test, you will use a slide with 6 reaction circles, marked as O, H, AH, BH, PC and NC. To begin with, Put one drop of the patient’s serum in four reaction circles, i.e., O, H, AH, BH. Add one drop of positive control in the PC circle and one in the NC circle. Next, add one drop of O antigen in the O circle, P antigen in the P circle, AH antigen in the AH circle, and BH antigen in the BH circle, respectively. Add any antigen, i.e., O, H, AH, BH in both PC and NC. Next, mix the serum and antigen in each circle properly so that the mixture doesn’t go out of the circle and touch the slide. Also, one mixture should not mix with another, as it can influence the test results. Finally, rotate the slide in a slow circular motion to ensure a proper mixture of serum and reagent. Once everything is done, you can see the results. If the test is positive, the test will be similar to the PC (+ve control circle), and if it’s negative, it will be similar to NC (-ve control circle). In other words, if there is any agglutination, the test results will be positive and vice versa.  Now, if the test results are positive, the next stage will involve a quantitative test. To confirm the diagnosis of typhoid fever, we will take the reagent of the antigen that is positive. For example, if O was positive in the qualitative test, we will take the O reagent in the quantitative test.  In most cases, O and H, i.e., S. Typhi are used to confirm the diagnosis. Only a few people have their AH or BH positive during a qualitative test. 2. A quantitative Widal test: It is a semi-procedure test, which means you will check for O if O is positive, H if H is positive, and both if both are positive. To perform this test, follow these steps: Use a different slide with 8 circles: four for O antigen and four for H. Now, if O was positive in the last test, put 5 ul patient’s serum in the 1st O circle, 10 ul in the 2nd, 20 ul in the 3rd, and 40 ul in the 4th circle horizontally. In the same way, put one drop of the specific reagent in all four circles.  To report, mark the values from the right side. Mark 1:40 on the fourth circle, 1: 80 on the 3rd circle, 1:160 on the 2nd, and 1:320 on the 1st circle. Interpretation of Widal Test-Slide Method After mixing the serum and reagent properly and rotating the slide, wait for the results to show. The result will be positive if it shows positive in more than 100 in the O circle and 200 in the case of H. In other words, it is a positive Widal test if the titre is above 100 in O and 200 in H. However, the results can be negative due to antibiotics, malaria, dengue, or the fever has affected you for more than a few days, etc. You can interpret your test results in the following ways: Negative if S. Typhi is smaller than or equal to 1:80 and positive if S. Typhi is more than or equal to 1:160. Negative if S. Paratyphi is smaller than or equal to 1:80 and positive if S. Paratyphi is more than or equal to 1:160. If S. Typhi O is positive, then you have an active fever. However, in the case of positive S. Typhi H, the fever is a past infection. Moreover, the Widal test normal range is when the titre is equal to or below 1:80 in both O and H antigens. Tube Widal Test Apart from qualitative and quantitative Widal tests, there is another test method; the standard tube method. Here, eight tubes are taken, diluted and observed. The first test can screen for typhoid fever; however, a tube Widal test effectively confirms a fever. Originally, two types of tubes were used to detect typhoid fever: Dreyer’s tube for H agglutination Felix tube for O agglutination Nowadays, 3 x 0.5 ml Kahn tubes are used for both O and H agglutination. Process of Standard Tube Method: To prepare for a Widal test, we would require the following objects: Patient’s serum O, H, AH and BH Antigens Normal Saline Pipette Test Tube Rack Test Tubes Water Bath Before beginning this test, it is essential to note that the tube method is a dilution technique that has to be done correctly. Let’s understand this test in a simpler language. First, take nine tubes and arrange them in the rack. In the case of O, mark the tubes in numbers from 1 to 9. Add and mix 0.1 ml normal saline and 0.9 ml serum in the first test tube. On the other hand, add 0.5 normal salines to each remaining tube. Next, take 0.5 ml from the 1st tube and add in the second. This will result in 0.5 ml remaining solution in test tube 1 and 1 ml in test tube 2nd. Repeat this process i.e., take 0.5 ml from the last tube and add it to the next tube to make it 1 ml. With the 8th tube, take 0.5 ml and keep that in another separate tube. Mix all the tubes properly. This will give us primary serial dilution of all the tubes from 1st to 8th as 1:10, 1:20, 1:40, 1:80, 1:160, 1:320, 1:640, and 1:1280, respectively. Take a new (9th) test tube and add positive control. Next, add 0.5 ml of respective antigen (O, H, AH, BH) in all eight tubes. This will make the final volume of each tube 1 ml. After adding a reagent to all the tubes, we will have the final serial dilution of all the tubes from 1st to 8th as 1:20, 1:40, 1:80, 1:160, 1:320, 1:640, 1:1280, 1:2580. Now, mix well, cover and incubate the tubes at 37° C overnight (18 to 24 hours). Interpretation of Widal Test-Tube Method If you have typhoid fever and there is some agglutination, you will see that the 9th tube (positive control) will look similar to one of the eight other tubes. If there is no enteric fever, there will be no change in the normal range of the eight tubes and widal test. If the tube that showed agglutination has a titre of more than 1:100 in case of O and 1: 200 in H, it will be widal test positive (active infection). Other than this, rest titers are considered the normal range of a widal test. Limitations of Widal Test No doubt, the widal test is a quick and effective way to diagnose typhoid fever, but it has some limitations as well, including: The results of the Widal test can be falsely positive in the case of past vaccination or S. Typhi infection. The Widal test is time-consuming; until a diagnosis is made, it becomes too late to start the treatment. A widal test can not distinguish between a patient's past infection, current infection, or a S. Typhi vaccination. The test results can be falsely positive in typhus, acute falciparum malaria, chronic liver disease, rheumatoid arthritis, nephrotic syndrome and myelomatosis.  Because so many factors can influence the test results, it is better to not just depend on this test for typhoid diagnosis. However, it is always best to choose trustable labs regarding screening. A delay or ineffective screening can cause a delay in the treatment. Price of Widal Test A widal test is a quick and affordable test which is mostly used in developing countries where typhoid fevers are prevalent. The widal test cost can differ based on location, lab centre and other criteria. With Metropolis Labs, the cost of the widal test is just xxx.  Our website features allow you to track your sample, download reports, book a home visit, upload prescriptions, etc. Contact metropolis labs today to book a widal test and get results quickly. Conclusion A Widal test is a quick procedure to diagnose typhoid fever or enteric fever. It only requires a patient's serum and some reagents to detect this fever. However, because different factors can influence the test results, it is always best to perform this test one week after the infection, following proper instructions.  If you have typhoid fever or are experiencing its symptoms, you can book a Widal test today.

The Origin of Zika Virus The Zika virus is a mosquito-borne flavivirus that spreads when an infected Aedes mosquito bites a person. The origin of the Zika virus goes back to 1947. A group of scientists was surveilling the Zika forest in Uganda for yellow fever. They isolated the Zika virus in the samples taken from a rhesus monkey and named it after the forest where they found it. The very next year, this virus was recovered from a mosquito.  The initial cases of the Zika virus in humans were reported from the United Republic of Tanzania and Uganda. Africa, America, Asia, and the Pacific Islands have also reported outbreaks of this virus. To date, nearly 86 countries have reported cases of the Zika virus.  The first confirmed Zika virus case in India was reported in Kerala in July 2021. In the same year, more cases were reported from Maharashtra, Uttar Pradesh, and New Delhi. How Does Zika Virus Spread through Aedes Mosquito? As mentioned above, the primary mode of transmission is the Aedes mosquito. Once this mosquito bites a person, the virus incubates between three days to two weeks infecting the person and starts growing in the bloodstream. When another uninfected mosquito bites this person, irrespective of whether the person has symptoms, the mosquito becomes a virus carrier, and thus, the vicious cycle of transmission goes on. What Are the Symptoms of the Zika Virus? Approximately 80 percent of people who contract the Zika virus do not experience any symptoms. If symptoms do occur, they are generally mild. In addition, Zika is unlikely to cause death or need hospitalization. So, what are the symptoms of the Zika virus? They can include: Rash Mild fever Conjunctivitis (red eyes) Joint pain, specifically in the feet and hands Headaches Myalgia (pain in the muscles) Arthralgia (joint pain) Pain in the eyes Muscle pain Pain in the abdominal area Fatigue Infection is dangerous during pregnancy, can lead to foetal microcephaly, preterm birth, miscarriage Can lead to Guillain-Barré syndrome, neuropathy and myelitis  The signs and symptoms can appear between 3-14 days after getting bitten by an infected mosquito. Call your doctor if you:  Experience any of the above symptoms Live in a virus-prone area Have visited a country affected by the Zika virus Are pregnant and suspect that you have the symptoms  How to Prepare for Your Appointment with the Doctor? You must see a doctor specializing in infectious diseases for this type of viral infection. You must know the following: Before prescribing a diagnostic test, doctors will inquire about your medical and travel history to determine whether you are a carrier of the Zika virus. So, try to be well-prepared with the necessary details like: If you came in contact with someone infected by this virus. The severity of your symptoms. If you got bitten by a mosquito while traveling. If you are pregnant. You can note down all these details before visiting the doctor. Also: Carry a record of your vaccinations. Make a list of any vitamins or supplements that you take regularly. Prepare a list of questions that you need to ask the physician, such as: Will I suffer any long-term health effects caused by this infection? What are the tests that I will have to undergo? How much time will I take to recover? What Are the Causes of the Zika Virus Infection? The causes and factors that increase the risk of getting this infection are: Mosquito bites: Infected Aedes mosquitoes are the primary carrier of the Zika virus. It includes the Aedes albopictus and Aedes aegypti species. These mosquitoes lay eggs and thrive in stagnant water, indoors and outdoors.  Blood transfusion: Although it is not confirmed, there have been reports from some countries where the Zika virus has been transmitted via blood transfusion. Mother to baby: The virus can spread from mother to baby during pregnancy or around childbirth. Not only this but the presence of this virus has also been found in breast milk.  Sexual intercourse: It is another cause of the spread of the Zika virus. There are even confirmed reports of the transmission of this virus through unprotected vaginal, oral, and anal sex. A person suffering from this infection can be a carrier of the Zika virus and can transmit this virus before the symptoms develop and after the symptoms subside. It is called asymptomatic transmission. Also, in contrast to blood and urine, semen remains active for a longer period than other bodily fluids.  How Is Zika Virus Diagnosed? The Zika virus infection can be diagnosed through blood or urine tests. Serological tests and nucleic acid detection based tests  are also  for diagnosis available to detect the presence of antibodies that your body produces to fight the infection. Some people may not show any associated symptoms, so it may go undiagnosed.  Metropolis Healthcare Ltd. offers Zika virus detection by RTPCR which is highly sensitive and specific. It is a gold standard test for diagnosis during the first 7 days of infection.  Doctors generally recommend getting tested for the Zika virus if a person exhibits symptoms after visiting a high-risk country or area or having unprotected sexual intercourse with a partner who has recently been to a Zika-infected place.  Another category of people who must get a test done is pregnant women. If you are pregnant and have been exposed to this virus, it is vital to get tested because there is a risk that your fetus may get this infection. Additionally, your doctor may require you to get a test if your fetal ultrasound shows Zika-related abnormalities. Doctors also advise Amniocentesis, which involves removing a sample of amniotic fluid by inserting a hollow needle into the uterus. The sample is then sent for laboratory testing.   What Are the Treatment Methods for the Zika Virus?  Since no vaccine and antiviral therapies are available, the Zika virus treatment essentially involves managing the symptoms. Usually, people infected with the virus recover well with over-the-counter medications.  Some methods can help in alleviating the symptoms of the Zika virus. The first and safest step is to visit a doctor. The next steps involve: Staying hydrated by drinking sufficient liquids like water, juices, and soups. Getting plenty of rest. Taking medication to reduce pain and fever. Informing your doctor about all the medications you have been taking at home after noticing the symptoms. Avoiding any non-steroidal anti-inflammatory drugs (NSAIDs) without consulting your doctor. Are There Any Ways to Prevent Zika Virus? The thumb rule is to keep mosquitoes at bay. Take precautions both indoors and outdoors to avoid mosquito bites.  You can follow the below-mentioned measures:  Use mosquito repellents. Sleep in air-conditioned rooms. Keep windows closed in the evenings when mosquitoes are highly active.  Wear long-sleeved t-shirts, shirts, and trousers that cover your legs properly. Use mosquito nets. Always cover a baby’s crib.  Install mosquito mesh on your doors and windows. It allows you to keep them open and, at the same time, prevents mosquitoes from entering your house. If you stay in an area with active Zika virus cases, it is recommended to use a condom during sexual intercourse. Even after you return from this area, you must continue to take precautions for a minimum of eight weeks.  If you are infected with the virus, you must use condoms for six months after recovering from it.  Another crucial measure to prevent the spread of this virus is to avoid donating blood if you return from a Zika-affected area. It is necessary to wait for 28 days to ensure there is no risk of infection. Couples trying to conceive must wait for about six months if either of the partners has traveled to a Zika-infected country or area (even if an infection was not confirmed). Avoid sexual intercourse with someone who has recently traveled to an area or country affected by this virus. Always keep the trash cans or dustbins at home clean. Check your planters, buckets, and coolers for any deposits of mosquitoes.  Can Zika Virus Cause Other Health Problems and Complications? Usually, with proper medications and rest, people recover from the Zika virus within a week. But, there can be some serious health complications, or the virus can result in other health problems, which can be:  Microcephaly: It is a birth defect in which babies are born with abnormally small heads. The virus prevents the brain from developing properly or blocks its normal growth. The Zika virus also escalates the risk of other congenital complications like: Hearing loss Ophthalmologic issues or vision-related issues  Limb contractures, and  High muscle tone Congenital abnormalities can result from both symptomatic and asymptomatic infection.  Guillain-Barré syndrome: People infected by the Zika virus are at a higher risk of developing the Guillain–Barré syndrome, an autoimmune neurological disorder. It is a rare health condition in which the body’s immune system damages the nerve cells, resulting in muscle weakness and paralysis. Most people recover from it, but this syndrome can cause permanent damage on rare occasions. Pregnancy-related complications: In some cases, the Zika virus infection can result in some complications during pregnancy like preterm birth, stillbirth, or in rare cases, fetal death. Hence, expecting couples must consult a pediatrician about the necessary precautions and care. Acute disseminated encephalomyelitis (ADEM): According to research presented at the American Academy of Neurology Conference, there is some connection between this virus and ADEM. In this disorder, the myelin coating around nerve fibers in the spinal cord and brain is damaged, and the symptoms are similar to those of multiple sclerosis. What Is the Current Scenario of the Zika Virus? In line with the Zika Strategic Response Plan, the World Health Organization (WHO) ensures complete support to all the countries in terms of detection, prevention, and care. The WHO also provides technical guidance and recommendations to healthcare professionals and policymakers. As of April 2019, there are no vaccines available for the Zika virus. However, some vaccines are under clinical trials. They are: DNA vaccine Live attenuated vaccine Purified inactivated vaccine  mRNA vaccine Viral vector-based vaccines Interesting Facts About Zika Virus Let us look at a few key facts about the Zika virus. The Zika virus was first reported in Uganda in 1947. If a woman is infected during pregnancy, the fetus can get infected. It can cause serious damage to the fetus’s brain. However, it is not clear which trimester is the most vulnerable period.  The Zika virus is one of those few viruses transmitted through sexual contact. The Aedes Aegypti mosquito is nicknamed ‘tiger mosquito’ because of its black and white stripes.  The Aedes Aegypti mosquito is also responsible for spreading the virus that causes chikungunya, yellow fever, and dengue.