 Hello one and all, I am Dr. Sanjithya S.B., Associate Consultant in Internal Department Medicine, Manipal Northside Hospitals, Malaysia. So today we are talking about seasonal diseases. Main thing during the monsoon seasons is that the change in humidity and also the change in temperature which increases the survival of various organisms and it also helps in the progression or multiplication of the organisms and there is also more contamination during this seasons and also there is transmission of various diseases and illnesses through various modes of transmission such as the food, air, water, flies and mosquitoes. So during rainy seasons the main thing is that the water bodies collected around surrounding us mainly during the such as the water collections on the roads or empty sites or the water collections, manmade water collections such as any empty materials which were thrown as deserted materials collected, water collected in that deserted materials. All those things are one of the risk factors. So broadly we can say that the fever, cold cough, diarrhea as decentries and various other diseases increased during the monsoons. So we broadly categorize the various diseases which appear into six categories. The first one let's go about with the diarrheal diseases. So diarrheas are very common disease during the rainy seasons mainly because of the contamination of the water or food whatever we are consumed and also there is mainly due to the contamination of food and water and it is one of the self-limiting illness and if the patient is having change in the consistency of these tools or if there are more than three tools per day it is usually self-limiting and also patient recovers with the household treatment in most of the times. Diarrheas are mainly risky in the children's mainly because of the higher risk of dehydration. Multiple loose tool episodes causes water loss in the children early and there is various degrees of dehydration is seen in children's. Children's usually require early consultation with the doctor because of the risk of dehydration. Dehydration is categorized into three various categories. Early dehydration usually there might not be any signs or symptoms. In the moderate degree of dehydration patient might have dryness of mouth, increase in thirst or increase in restlessness and all. In severe dehydration patient might go into diminished consciousness state or patient might develop low BP and also decreased urine output can be seen. Another part of diarrheal diseases is the dysentery wherein the severity of the loose tools increases and also the loose tools is usually associated with blood in these tools. So in such cases it is a little risky for the patient to continue staying at the home. Patient needs to visit the nearby hospital because of the risk of blood loss and also because of the risk of shock. The main thing which is associated with dysentery is the association of pain abdomen and fever in the patient. This differentiates between the normal diarrhea and the dysentery. The amoebic dysentery is the another entity wherein the patient goes into long term diarrheal illness where the patient might not have very severe illness and also patient might continue to have loose tools daily for longer periods and it goes into a chronic state. Another intestinal pathology or infection is the typhoid fever. Here the main source is through the food contaminated food and water. Here the pathogenic organism is salmonella typhi, the bacteria which causes typhoid fever. It usually is transmitted through food through our intestines where it gets into our intestines and causes ulcer like illness in the intestine and it usually presents as a fever, pain abdomen, loose tools in the initial phases. In the later stages patient will start developing high grade fever and sometimes patient might also develop blood in the tools. So regarding the preventing of typhoid patients should avoid outdoor foods and should use safe drinking water during the travel or in case of rainy seasons he should maintain food and water sanity. There are also various typhoid vaccines which are available. You can visit nearby hospitals to know about the vaccine which are usually given through oral dose. The next thing we are talking about is cholera. So cholera is also one of the diarrheal diseases wherein the patient will go into severe dehydration in the very early stages. Usually the patient will be having loose tools, multiple episodes associated with vomiting. The loose tools are compared with the rice water tools because the consistency and the appearance of the loose tools is similar to the drained rice water. So it is very necessary to identify the cholera in the earlier stage because patient going into severe dehydration can have renal failure also in the severe stages. So it is very important to identify cholera in the earlier stages. This disease was very common during earlier because of poor water sanitation. Nowadays it is seen little rare but it is very severe if it is seen. This is all about the diarrheal illnesses. This was just a brief thing to know about the various diseases which appear during rainy season or any other season change in monsoons, change in season which will cause the affect our intestines. So the next entity which we are discussing about is the liver diseases. So liver diseases usually are also more common during rainy seasons mainly because of the contaminated water and food hepatitis. So hepatitis A is one of the common disease which is affecting the liver during the monsoons and the patients usually present with fever, malaise, generalized weakness, fatigue and also patients usually have vomiting, loose tools and also yellowish discoloration of the eyes. So these are the common symptoms which are seen in a hepatitis A patient. So there is also history of travel is present in this patient. So who are travelling to different places usually and later developing such symptoms we should think of mainly the discriminating feature is the yellowish discoloration of eyes. Yellowish discoloration of eyes will more give a clue that patient might be having hepatitis A. So prevention of hepatitis A mainly as similar with the diarrheal diseases food and water sanitation and also there are various vaccines which are available for hepatitis A which are given orally you can visit nearby hospitals to know more about the vaccines. The next common things which are common disease which is seen during the rainy seasons or monsoons is that cough and colds which is generally called as viral fevers. Cough and cold is the most common during rainy seasons it is usually due to the viral infection which every year comes with a new strain causing a new infection but it is usually self-limiting and more limited to the upper respiratory tract and patients usually recover within 3 to 4 days with the home remedies. So until now we have discussed the three important diseases that is the diarrheal illnesses digestive system diseases including diarrhea and dysentery, liver diseases including hepatitis A which is the most common and also cold cough which affects the upper respiratory tract. Coming to the next one we are discussing regarding the mosquito-borne diseases. So mosquito-borne diseases are increased during the monsoon seasons because of the water bodies collecting surrounding us on the roads or the empty sites or whatever the man made collection such as empty bottles, empty whatever the things which where the water gets collected. So these become the breeding spaces for the mosquitoes which are the main vectors for the various diseases. So we will just discuss regarding the various diseases which are due to the vector-borne diseases that is mosquito-borne diseases. The first important thing we will discuss is malaria. Malaria is one of the important vector-borne diseases mainly transmitted by the anaphylus mosquito. So the plasmodium virus affects the blood cells of our body, red blood cells and also it affects the liver. It usually causes the symptoms of the malaria or like high fever which is seen alternate day every alternate day and it is also associated with severe chills sometimes associated with vomiting and also loose tools. So patients usually have multiple organ dysfunction usually their liver will also be affected and patient will I might also go into anemia that is decreased blood counts because of the lysis of the red blood cells. So usually it is mild to severe. In mild cases patients simply presents with fever and chills and vomiting and in case of severe malaria patient might have decreased consciousness due to the malaria organism affecting our brain. In that case patient is termed as cerebral malaria wherein patient will be in the severe disease. Patient might also have low glucose levels. Patient might also have low sugar levels because it affects the liver also. Next mosquito-borne disease is the dengue. Here patient it is a viral illness which is caused by dengue virus. So the it is also a mosquito-borne disease because of the ADS-Egypti. So ADS-Egypti is the mosquito which transmits dengue fever. So usually this is also seen due to the water body collection surrounding us and mainly the daytime sleepiness is the main risk factor for development of dengue. Here the patients usually might be having very mild disease and also might go into severe disease. So in case of mild disease patients usually have just fever, body ache and retro orbital pain what we call that is the pain behind the eyes and patients might also have severe back ache. So it is also called as break bone fever because the severity of the back ache is so severe that it is also termed as break bone fever. So patient might develop fever and all the symptoms and might be self-limiting for 3 to 4 days but the main risk factor associated with the dengue is the dropping of the platelet counts. So dropping of the platelet counts is usually seen after 3 to 4 days of the illness even after the fever subsides. It is very likely for the patient to stay at home after the fever episode because that is when patient usually starts where the platelet starts dropping. So it is very necessary to get an evaluation done in the early stage so that the dropping of platelets can be identified. If the platelets drop to a very severe level patient might start having bleeding manifestations various bleeding manifestations such as gum bleeding or bleeding under the skin or life threatening bleeding also in the all the cavities of the body such as cranial cavity or abdominal bleeding also. There is also we can categorize the dengue fever into two other severe forms that is dengue hemorrhagic fever it is called and also dengue shock syndrome dengue hemorrhagic fever as I said the patient will have bleeding from high risk of bleeding from all the parts or also from the into the cavities various body cavities such as abdominal cavity cranial cavity and also bleeding through the through urine and also through the hemoptysis patient can have hemoptysis that is bleeding when he coughs. So this is categorized as dengue hemorrhagic fever. Coming to the dengue shock syndrome here the patient might go into a very low blood pressure state because of the highly inflammatory reaction in the body the patient can have patients blood pressure might drop below to the severe state where patient might go into shock. In case of mild dengue fever where in the platelets have not dropped very much or the patient's blood pressure is maintaining only symptomatic treatment is advised such as paracetamol and good hydration. In case of and patient needs to be monitored for the platelet levels and also other parameters if the platelet levels are dropping below a particular level say 70 or 50000 patient needs admission and also monitoring of the platelets if they are dropping below the 20,000 the patient might require transfusion of platelets also mainly the management stays supportive but mainly but the main concern is to monitor for the dangerous signs and symptoms. Coming to the next mosquito-borne disease is the chicken gunia. Chicken gunia usually is a viral disease affecting the all the joints it starts with the fever which is high grade around 101 to 102 and patient will also start developing joint pains involving all the joints small joints and large joints of the body the it is a very debilitating disease usually the joint pains run for a period of months together sometimes patients might have long running joint pains which does not subside even with the painkillers. Next thing we are discussing about is the bites animal bites during rainy seasons animal bites also increase mainly the snake bite which is more commonly seen in rural areas. So the snake bites the risk associated with the snake bites is that patient might have neurological weakness because of cobra snake bite and patient might have bleeding tendencies because of other snakes such as crate or wiper. So coming to the last thing which we are discussing is the leptospira. Leptospirosis is also one of the common diseases during the rainy seasons and more commonly seen in lower socioeconomic status. This is an bacterial disease which is caused by a bacteria leptospira. So this bacteria is mainly spread through the contaminated water which is contaminated by the animal feces such as rats and mice. So the water which is contaminated with this leptospira if a person is having an open wound gets exposed with that contaminated water that leptospira enters our body. Leptospirosis is it affects the multiple organs. Patient might have liver failure and renal failure also. It can range from mild to moderate. In case of mild disease patient might have fever, chills, body pain, joint pains and also cough, muzzle pain. In case of severe disease patient might develop jaundice where it is called as Veal's disease. We have briefly described about the all the diseases which are necessary to identify at the earlier stage and to present to the or consult a doctor to the earlier stage. Now we will just discuss regarding the general preventive measures. So safety of the food, vegetables and water what we consume is very necessary hand washing before and after food consumption is also very important. Proper sanitary disposal is an important measure to be carried out and in case of vaccines patients can visit nearby hospitals to enquire regarding the vaccine. Measures for water safety is the during travel to carry safe water or boiled water and also the filtered water. Food safety is also an important measure. You have to avoid stale food, use fresh food which is cooked properly, avoid under cooked food. Another major thing is the water collections around us. It is very necessary to regularly empty the water collections and also use mosquito nets to avoid mosquito bond diseases. Thank you for joining the live session. If you are having any queries regarding the seasonal diseases discussed till now you can just feel free to ask the queries in the below comment box. We will be happy to answer those queries and we will further meet in the next sessions. Thank you.