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The time between the bite of a mosquito carrying dengue virus and the start of symptoms averages from 4 to 6 days, with a range of 3–14 days.

Dengue should be suspected if you have a sudden onset of high fever, which could reach 39–40°C (103–105°F).

  • severe headache(mostly in the forehead),
  • pain behind the eyes,
  • body aches and pains,
  • skin rash
  • nausea or vomiting.

Apart from the clinical features, there are laboratory tests which can confirm dengue infection. The tests include antigen detection tests which are the earliest to become positive(dengue NS 1antigen), and antibody detection tests, which become positive after day 5 of the illness(dengue serology IgM and IgG).

Yes. It is possible to get dengue more than once. There are four different strains (serotypes) of the dengue virus. If a person has suffered from one virus, there can be a repeat occurrence if a different strain is subsequently involved. Subsequent infections with different serotypes increases the risk of severe complications.

White spotted body and legs and is easy to recognize. The Aedes aegypti mosquito mostly rests indoors,in closets and other dark places, and in cool and shaded places outdoors. The female mosquito lays her eggs in water containers.It breeds in clean water and has a flight range of only 100–200 m. The mosquito picks up the dengue virus after biting someone already infected with the virus.

Dengue is not contagious. It does not spread directly from person-to-person through physical contact. When an infected person is bitten by a mosquito, the mosquito might later bite other people. Therefore, patients should be protected against contact with mosquitoes.


For every patient with symptoms and signs there may be four or five persons with either no symptoms or very mild symptoms.

Most patients with dengue fever can be treated at home. They should

  • take rest,
  • drink plenty of fluids
  • maintain a nutritious diet.
  • oral rehydration salts (commonly used in treating diarrhoea) should be taken. Sufficient fluid intake is very important.
  • Like most viral diseases, there is no specific cure for dengue fever.
  • Antibiotics do not help.
  • Paracetamol is the drug of choice to bring down fever and joint pain.

Other medicines such as aspirin and ibuprofen should be avoided since they can increase the risk of bleeding.

The infection can become dangerous since it may damage the blood vessels causing leakage of blood fluid/plasma into various organs, completely broken blood vessels that cause bleeding.

The symptoms and signs of dengue haemorrhagic fever and dengue shock syndrome(Severe forms of dengue) are related to damage to the blood vessels and low platelet count. Death can occur in some of these cases if they are not treated in time.


You should be immunized against flu (each autumn) and also against the pneumococcus bacteria (just given once). These infections can be particularly unpleasant if you have diabetes.

Currently, there is no cure for type 2 diabetes.

A simple ‘dipstick’ test may detect glucose in a sample of urine. However, this is not sufficient. A fasting and a post prandial sugar done two hours after meals maybe done. More precisely, a glucose tolerance test with 75gram glucose maybe done. Glycosylated haemoglobin(HbA1c)is a test which gives you the average of blood sugar for the past 3 months.


In many cases diabetes is diagnosed during a routine medical or when tests are done for an unrelated medical condition.

Short-term complication – a very high blood glucose level


A very high blood level of glucose can cause dehydration, drowsiness and serious illness which can be life-threatening.

Long-term complications

If your blood glucose level is higher than normal over a long period of time, it can gradually damage your blood vessels. This may lead to some of the following complications often years after you first develop diabetes:

  • Atheroma or hardening of blood vessels due to deposition of cholestetol. This can cause problems such as angina, heart attacks, stroke and poor circulation.
  • Kidney damage which sometimes develops into kidney failure.
  • Eye problems, which can affect vision.
  • Nerve damage.
  • Foot problems (due to poor circulation and nerve damage).

The type and severity of long-term complications vary from case to case. You may not develop any at all. In general, the nearer your blood glucose level is to normal, the less your risk of developing complications.

Complications of treatment

Hypoglycaemia (which is often called a ‘hypo’) occurs when the level of glucose becomes too low. A hypo may occur if you have too much diabetes medication, have delayed or missed a meal or snack, or have taken part in unplanned exercise or physical activity.

Symptoms of hypoglycaemia include: trembling, sweating, anxiety, blurred vision, tingling lips, paleness, mood change, vagueness or confusion. To treat hypoglycaemia you should take a sugary drink or some sweets. Then eat a starchy snack such as a sandwich.

Although diabetes cannot be cured, it can be treated successfully.


Therefore, the main aims of treatment are:

  • To keep your blood glucose level as near normal as possible.
  • To reduce any other ‘risk factors’ that may increase your risk of developing complications. In particular, to lower your blood pressure if it is high, and to keep your blood lipids (cholesterol) low.

To detect any complications as early as possible. Treatment can prevent or delay some complications from getting worse.

You can self monitor blood sugar with a glucometer. The HbA1c test measures a part of the red blood cells. Glucose in the blood attaches to part of the red blood cells. This part can be measured and gives a good indication of your average blood glucose level over the last 3 months.Treatment aims to lower your HbA1c to below a target level . The target level is usually somewhere between 6.5% and 7.5%. If your HbA1c is above your target level then you may be advised to ‘step up’ treatment to keep your blood glucose level down.


Lifestyle – diet, weight control and physical activity

In Type 1 diabetes the beta cells in the pancreas stop making insulin. The illness and symptoms develop quickly (over days or weeks) because the level of insulin in the bloodstream becomes very low. Type 1 diabetes used to be known as juvenile, early onset, or insulin-dependent diabetes. It usually first develops in children or in young adults. Type 1 diabetes is treated with insulin injections and diet.

Type 2 (formerly called ‘adult-onset’ or ‘non insulin-dependent’) usually occurs in people who are over 40 years of age, overweight, and have a family history of diabetes, although today it is increasingly found in younger people. It occurs because:


  • You do not make enough insulin for your body’s needs,
  • The cells in your body do not use insulin properly. This is called insulin resistance.
  • A combination of the above two reasons

Type 2 diabetes is much more common than Type 1 diabetes.

  • The incidence of diabetes in India is increasing so fast, that it may have the maximum number of diabetes in the world in the next decade. Other risk factors for Type 2 diabetes include:


    • Having a first-degree relative with Type 2 diabetes. (A first-degree relative is a parent, brother, sister, or child.
    • Being overweight or obese.
    • Having a waist measuring more than 31.5 inches (80 cm) if you are a woman or more than 37 inches (94 cm) if you are a man.
    • Having impaired glucose tolerance. (Impaired glucose tolerance is when your blood glucose levels are higher than normal but not high enough to have diabetes.

    Having diabetes or impaired glucose tolerance when you were pregnant.

People with type 2 diabetes frequently experience certain symptoms. These include:


  • being very thirsty
  • frequent urination
  • blurry vision
  • irritability
  • tingling or numbness in the hands or feet
  • frequent skin, bladder or gum infections
  • wounds that don’t heal
  • extreme unexplained fatigue

The reason why you make a lot of urine and become thirsty is because glucose leaks into your urine which ‘pulls out’ extra water through the kidneys.

Type 2 diabetes is often treated with oral medication because many people with this type of diabetes make some insulin on their own. The pills people take to control type 2 diabetes do not contain insulin. Instead, medications such as metformin, sulfonylureas, alpha-glucosidase inhibitors and many others are used to make the insulin that the body still produces more effective.


Some people with type 2 diabetes are treated with insulin. Insulin is either injected with a syringe or pen device several times per day, The goal of insulin therapy is to mimic the way the pancreas would produce and distribute its own insulin, if it were able to manufacture it. Taking insulin does not mean you have done a bad job of trying to control your blood glucose-instead it simply means that your body doesn’t produce or use enough of it on its own to cover the foods you eat.


It is an OPD procedure which takes about 30 min for both eyes.

Yes, it is the safest and one of the most advanced surgeries in the world.

Most patients are seen the day following the treatment and then at least after 1 month and 3 months following the treatment. Some patients require more visits.

Yes, following an initial healing period of 2-3 months, the effect is life long.

Patients over 40 yrs may need magnification for reading fine print. Lasik does not correct or prevent Presbyopia.

You can bathe the same day as the treatment but do not shower for2-4 days after treatment. Avoid getting soap or water directly into your eyes. Avoid rubbing your eyes during 1st month of surgery.

You should not drive the day of treatment. After that you may drive when you feel Confident that your visual acuity and eye comfort allow you to drive safely.

No, the procedure is painless and the patient only experiences slight pressure sensation. The procedure itself is very comfortable for the patient.

One can resume the normal activities as early as after 24-48 hrs of the surgery with only a few precautions.

No, there has been no reported case of blindness so far.

  1. Standard Lasik- Treats only Refractive error ( sphere/cylinder)
  2. 2 Custom Lasik- Besides treating Refractive error it also measures and treats High Order Aberrations present in the optical system of the eye and hence gives better contrast and night vision.

Within 1 month of treatment.

Non-contact sports can be started as soon as one feels comfortable. Eye protection for racket or rough sports is required.



Topical Anaesthesia (numbing eye drops) is used.

Normally both eyes are treated at the same time as this prevents the patient being near-sighted in one eye between treatment. You may elect to get one eye treated at a time.

Each patient it is different. Most patient notice a dramatic improvement ever as they leave the clinic.

Most patients are back to work a day after treatment.

No. You should wear protective eye shields for 1 week at bedtime for protection.

A typical schedule for LASIK patient is –


Day 1. Detailed eye examination

Day 2. LASIK surgery (2-4 hours spent at centre)

Day 3. Review visit after surgery

Day 7. Review examination

Although a relatively safe procedure, the possible complications can be –


Under or over correction, Glare/Decreased contrast sensitivity, Flap damage, Decentered ablation, Cornea, perforation and Infection

95% of the people will be totally free from their spectacles. 5% will have mild variations from their zero targeted correction due to varying healing patterns in different individuals, but will have their dependency reduced on spectacles.

Yes, the treatment is designed to last a lifetime.

  • Standard lasik – Treats only refractive errors (sphere/cylinder)
  • Custom lasik – Corrects refractive error along with optical aberrations of eye resulting in a sharp vision.
  • E-LASIK – Corneal tissue saving procedure for patients with thin corneas. Thin epithelial flap made. If epithelium is removed using alcohol then it is called Lasek.
  • I LASIK – The flap is lifted up by a laser called a Femtosecond laser instead of a micro-kerotome. The usual laser is used to correct the refractive error and the flap is then placed back where it self heals. Since a laser is used instead of a micro-kerotome blade to cut the flap, it is also promoted as a bladeless technique. The results of i-lasik and normal LASIK are similar.