A Simple Guide to Folliculitis

A Simple Guide to Folliculitis
-----------------------------------------

What is Folliculitis?
--------------------------

Folliculitis is an infection of the hair follicles.

What are the causes of Folliculitis?
-------------------------------------

Folliculitis may occur after:
1. abrasions or wounds on the skin

2.friction due to tight clothing

3.eczema or dermatitis

4.diabetes or leukemia patients are more susceptible to infection

The bacteria causing the folliculitis is usually staphylococcus aureus.

What are the symptoms and signs of Folliculitis?
---------------------------------------------

There is usually a superficial pustule or inflammatory nodule surrounding the base of a hair.

They may occur all around the same area or scattered on the body.

Chronic Folliculitis may occur around the beard area.(sycosis barbae)

What are the complications of Folliculitis?
-------------------------------------------

The inflammatory nodule of Folliculitis may develop into a pustule with cental necrosis and discharge of pus and sometimes blood stained material.
This is a furuncle or boil.

A group of furuncles can merge and become a larger entity called a carbuncle which is deep and wide .

What is the treatment of Folliculitis?
---------------------------------------

Most mild Folliculitis may disappear by itself without treatment after a few days.

The severe cases requires topical antibiotic creams like bactroban or systemic antibiotics to clear the infections.

Carbuncles may need surgical treatment.

A Simple guide to Whooping Cough

A Simple guide to Whooping Cough
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What is Whooping Cough?
-----------------------

Whooping cough is an acute infectious childhood disease of the respiratory tract caused by the bacillus Bordetella pertussis.

How is Whooping Cough transmitted?
---------------------------------

Whooping Cough is transmitted by droplets from coughing spells.

It is highly infectious.

The early stage when it appears to be a cold is the most infectious peroid.

Most infections occur in children under six years of age.

One attack usually confers immunity

What are the Signs and Symptoms of Whooping Cough?
---------------------------------------------------

The incubation peroid is usually 10 - 12 days after contact with an infected child.
Symptoms start off with:
1.an ordinary cold (runny nose, sneezing, cough, fever) for 1-2 weeks followed by:

2.uncontrolled coughing that can last 1 - 2 months.

Cough persists and become paroxysmal ending in a noisy inspiration "whoop" sound causing the child to go blue and vomit.

Between the spasms of coughing the child seems relatively well

What are the complications of Whooping Cough?
---------------------------------------------

The worst affected are children below the 1 year old.
Some serious complications are:
1.pneumonia,

2.seizures,

3.brain damage

4.nose bleeds

5.death can occur during the severe coughing stage.

Serious complications are less with older children or adults.

Adults rarely get whooping cough because their immmunity from vaccination usually last 10 years after the last dose.

When adults get whooping cough, a prolonged, irritating cough may be present instead of whooping type of cough.

What is the Treatment of Whooping Cough?
--------------------------------------------

Antibiotics (erythromycin) are used in the treatment of Whooping cough.

Once severe coughing has begun, antibiotics are less effective. They can reduce the duration of the illness and stop the spread to others.

Family members should be treated once there is an infected person.

Tetracycline is used if the patient is allergic to erythromycin but should avoided in children because of the staining of the teeth.

Besides antibiotics, the following will help:
1.Steam inhalation

2.cough mixtures

3.oxygen therapy

4.avoid smokes, dust, dry air,sudden temperature change

What is the Prevention for Whooping Cough?
-----------------------------------------

Vaccination against whooping cough is the best prevention .

Since vaccination began, the worldwide incidence of whooping cough has declined.

Vaccination against diphtheria, pertussis (whooping cough), tetanus (DPT) is usually given to a baby at 3 months of age and repeated at 4 and 5 months of age.

There is a booster vaccination at 18 months.

In very rare cases (1 in 100,000 cases), there has been serious reactions such as seizures to the whooping cough part of the vaccination.

Recently, an improved acellular pertussis vaccine is now available. There are fewer side effects such as high fever and seizureswith this new vaccine.

A Simple Guide to Dysmenorrhea

A Simple Guide to Dysmenorrhea
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What is Dysmenorrhea?
-----------------------------

Dysmenorrhea is a symptom, not an illness.
It means painful menstruation.

What are the types of Dysmenorrhea?
--------------------------------------------

Dysmenorrhea may be classified into:

1.Primary or Spasmodic Dysmenorrhea

2.Secondary Dysmenorrhea due to causes like

Endometriosis or

Pelvic Inflammatory Disease

What are the Causes of Dysmenorrhea?
----------------------------------------------

The cause of primary Dysmenorrhea is still not known.

There are a few theories:
1.during menstruation, contraction of the uterine muscles occurs in spasms trying to push the menstrual flow through a narrow cervical opening

2.Prostagladins output occurs at time of menstruation producing muscles spasms

3.Menstrual clots occludes the uterine opening and requires more contractions of the uterine muscles to push it through

4.Stress may constrict the opening of the uterus and hence greater contraction of the uterine muscles is required to force out the menstrual flow.

What are the Symptoms of Dysmenorrhea?
--------------------------------------------------

Primary Dysmenorrhea:
----------------------------

1.typically occurs on the first day of menses and becomes less after the 2nd day.

2.lower abdominal cramp radiating down to thighs and back

Secondary Dysmenorrhea:
-------------------------------

1. Starts about 1 week before menses and reach maximum on first day before reducing intensity for rest of menses peroid

2.dull aching pain in lower abdomen with radiation to the back

Symptoms may be associated with
1.vomiting,

2.urinary frequency,

3.headache,

4.painful breasts,

5.abdominal distension,

6.depression and

7.irritabilty.

What is the Treatment for Dysmenorrhea?
--------------------------------------------------
Primary Dysmenorrhea:
----------------------------

1.simple analgesics like paracetamol

2.Non-steroidal anti-infammatory drugs like Ponstan, Synflex

3.Antispasmodics

4.Tranquilliser or antidepressant

5.Muscle relaxant

6.female hormones

Secondary Dysmenorrhea:
-----------------------------------

1.Identify and treat the underlying cause(eg. antibiotics for PID)

2.Endometriosis may require a course of female hormones or surgery for control

3.Dilatation of the endocervical canal may help

What is the prognosis of Dysmenorrhea?
------------------------------------------------

Primary Dysmenorrhea may end with first pregnancy due to widening of uterine opening.

Secondary Dysmenorrhea prognosis depends on the treatment of causes.

A Simple Guide to Laryngitis

A Simple Guide to Laryngitis
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What is Laryngitis?
------------------------

Laryngitis is the inflammation of the mucous membranes of the Laryngx which produces the sound of the voice.

What causes the Laryngitis?
---------------------------------

Laryngitis is caused by
1.bacterial or viral infections of the larynx.

2.excessive use of voice

3.inhalation of irritants such as cigarette smoke

Laryngitis is also associated with
1.bronchitis

2.pneumonia

3.whooping cough

4.diphtheria

What are the Symptoms of the Laryngitis?
--------------------------------------------------

Laryngitis produces mild but uncomfortable symptoms:

1.hoarseness of voice

2.loss of voice

3.pain on speaking

4.Fever low grade rare

How is the diagnosis of Laryngitis confirmed?
------------------------------------------------------

1.Symptoms of hoarseness or loss of voice

2.Physical examination of the throat may showed the presence of redness and swelling of the vocal cords with some pus discharge.

The movement of the vocal cords may be impeded.

Sometimes nodules may be found on the vocal cord due to excessive usage of voice.

What are the investigations done in Laryngitis?
-----------------------------------------------------------

1.nasal and throat swabs to determine the type of infection

2.Xray of the chest and neck to determine any pressure of other organs pressing on the larynx

3.A biopsy of the nodules on the vocal cords if present to exclude malignancy

What is the Treatment of Laryngitis?
---------------------------------------------

1.Rest the voice. A rested patient will recover faster.

2.Adequate warm fluids helps to keep the mucus membranes moist

3.Steam inhalations may help

4.Antibiotics if there is suspicion of bacterial infection.

5.Gargles and decongestants may help to soothe the throat and vocal cords

6.Avoid smoking.

What is the prognosis of Laryngitis?
------------------------------------------

Acute laryngitis usually clears up within 10 days.

Very rarely chronic laryngitis may cause hoarseness of voice for months or years.

A Simple Guide to Leprosy

A Simple Guide to Leprosy

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What is Leprosy?

---------------------

Leprosy or Hansen's disease is a chronic granulomatous disease caused by the bacteria mycobacterium leprae.

Who is at risk of contacting Leprosy?

--------------------------------------------

At present 10 countries: Brazil, Democratic Republic of the Congo, Guinea, India, Indonesia, Madagascar, Mozambique, Myanmar, Nepal and Tanzania account for 90 per cent of the disease in the world.

The disease affects mainly young people between 10-20 years of age, males more than females.

The exact mode of spread is unclear.

It is believed to be from person to person via nasal discharge, respiratory droplets and skin contact.

People prone to contacting the disease have:

1.weak immune system -these people develop multibacillary leprosy which is infectious,

Those with a stronger immune system develop paucibacillary leprosy which is non-infectious:

2.malnutrition and

3.unhygienic and crowded living conditions

What are the Signs & Symptoms of Leprosy?

----------------------------------------------------

The incubation period can vary from 1 year - 40 years.

Paucibacillary leprosy:

1.milder and non-infectious

2.one or more hypopigmented skin macules with loss of sensation.

3.Peripheral nerves may be damaged and enlarged.

Multibacillary leprosy :

1.numerous shiny, reddish nodules, thickened skin,

2.nasal discharge, nasal congestion and bleeding from the nose.

3.Distal peripheral nerves are thickened, enlarged and painful.

4.loss of eyelashes and eyebrows.

5.Skin smears are always positive for bacilli.

How is the diagnosis of Leprosy made:

---------------------------------------------

Diagnosis of leprosy is based on the following signs:

1.chronic skin lesions,

2.peripheral neuropathy,

3.thickened nerves,

4.muscle weakness

Confirmation of diagnosis is by

1.biopsy of skin lesions and thickened nerve.

2.Nasal and skin smears may show presence of leprosy bacteria.

What are the Complications of Leprosy?

------------------------------------------------

Complications include

1.damage to the peripheral nerves

2.numbness,

3.muscle weakness

4.paralysis with consequent claw hand or foot drop

5.skin 6. painful skin nodules.

6.loss of sensation, with resultant injuries

8.infections from injuries which can cause ulcers that damage the dermal tissues,

9.joints and bones infections resulting in the loss of extremities (toes and fingers)

10.secondary crippling deformities can occur in 25 per cent of cases not treated at an early stage.

What is the Treatment of Leprosy?

-----------------------------------------

Leprosy can be cured.

Early Treatment averts disability.
Multidrug therapy (MDT) consists of three drugs:

dapsone,

rifampicin and

clofazimine.

This drug combination effectively kills leprosy bacteria.
It prevents mutilations and deformities.

The 80 per cent with paucibacillary leprosy (PB) are non-infectious and cured within six months.

The remaining 20 to 30 per cent with the multibacillary form (MB) are cured within one year.

The drugs are safe with little side effects.

After the first dose of MDT, the patients are no longer infectious .

There is virtually no recurrence of the disease with treatment.

No resistance of the bacillus to MDT has been detected.

The chain of transmission of the leprosy is stopped.

What is the Preventive measures for Leprosy?

------------------------------------------------------

Prevention measures are:

1. early detection and treatment with MDT has prevented about 3 to 4 million people from being disabled.

2.Better hygience and nutrition

3.Better living conditions

A Simple Guide to Pelvic Inflammatory Disease

A Simple Guide to Pelvic Inflammatory Disease
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What is Pelvic Inflammatory Disease?
---------------------------------------------

Pelvic inflammatory disease (PID) is a general term used to describe inflammatory disorders of the upper female genital tract, such as infection of the uterus, fallopian tubes, ovaries and tissues around the reproductive organs.
These include endometritis, salpingitis, tubo-ovarian abscess, and pelvic peritonitis.

What is the cause of PID?
------------------------------

It is the result of infection from some sexually transmitted diseases especially chlamydia and gonorrhea.

The fallopian tubes and tissues in and near the uterus and ovaries are the most frequent organs damaged.

Sexually active women in their childbearing years are most likely to get PID.
Women under age 25 are more likely to develop PID than those older than 25.
The cervix of young women is not fully matured, and therefore more prone to be infected by STD.

Vaginal douching in women changes the vaginal bacteria flora in harmful ways, and can also force bacteria into the upper reproductive organs from the vagina.

Women with an intrauterine device (IUD) inserted has an increased risk of PID compared with women using other contraceptives or no contraceptive at all.

What are the signs and symptoms of PID?
--------------------------------------------------

Symptoms of PID can vary widely.
Women whose PID is caused by chlamydial infection may have mild symptoms or no symptoms at all even as serious damage is being done to her reproductive organs. Most cases of PID are not detected about two thirds of the time.

Common symptoms of PID are
1.lower abdominal pain
2.fever,
3.unusual vaginal discharge with a foul odor,
4.painful intercourse,
5.painful urination,
6.irregular menstrual bleeding, and
7.pain in the right upper abdomen (rare).

How is PID diagnosed?
---------------------------

Because the symptoms are often subtle and mild, most cases of PID go undetected.

Diagnosis is usually based on clinical findings:
1.lower abdominal pain

2.abnormal cervical or vaginal mucopurulent discharge

3.oral temperature >101°F (>38.3°C)
together with investigation findings
4.laboratory evidence of gonorrheal or chlamydial infection.

5.A wet specimen of vaginal fluid is able to detect the presence of concomitant infections ( bacterial vaginosis and trichomoniasis)

6. pelvic ultrasound is a helpful procedure for diagnosing PID.It can check the pelvic area to see whether there is an abscess or enlarged fallopian tubes.

7.laparoscopy is a minor surgical procedure in which a thin, flexible tube with a lighted end in inserted through a cut in the navel area to view the internal pelvic organs and to take specimens for testing.
Other criteria for diagnosing PID include the following:
8.endometrial biopsy with histopathologic evidence of endometritis;

9.transvaginal sonography or magnetic resonance imaging techniques showing thickened, fluid-filled tubes with or without free pelvic fluid or tubo-ovarian complex,

10.doppler studies suggesting pelvic infection

What are the complications of PID?
-----------------------------------------

Prompt and appropriate treatment can help prevent complications of PID.

Without treatment, PID can cause

1. permanent damage to the female reproductive organs.
Infection-causing bacteria can invade the fallopian tubes, damaging the lining of the tubes causing blockage of the fallopian tubes and preventing sperm from fertilising an egg.

2.Infertility also occur when the fallopian tubes are partially blocked or even slightly damaged as therm may find it difficult to reach the egg.

3.ectopic pregnancy may occur when the fertilized egg remains in the partially blocked fallopian tube and begins to grow.
As it grows, an ectopic pregnancy can cause rupture of the fallopian tube resulting in abdominal pain, internal bleeding, and death.

4.chronic pelvic pain that lasts for months or even years due to the inflammation, damage to the pelvic organs, and contraction of the scarred tissues.

5.endometrosis are blood clots in the pelvic region which occurs due to inflammation of the pelvis and can also cause pain during menses.

6. abscess formation in the reproductive organs or pelvis which can spread to the blood and cause septicemia.

What is the treatment for PID?
-------------------------------------

Treatment of PID should be initiated in
1.sexually active young women

2. pelvic or lower abdominal pain,

3. physical examination shows cervical motion tenderness, uterine tenderness or adnexal tenderness.

PID can be treated with several types of antibiotics(eg.clindamycin or metronidazole with doxycycline).
However, antibiotic treatment will not reverse any damage to the reproductive organs. If a woman has pelvic pain and other symptoms of PID, it is important that she seek care immediately.
Prompt antibiotic treatment can prevent severe damage to reproductive organs.

PID is usually treated with at least two antibiotics given by mouth or by injection.
Even if symptoms go away, the woman should finish taking all of the prescribed medicine.
This will help prevent the infection from returning.

Hospitalization to treat PID may be recommended if the woman
(1) is severely ill with nausea, vomiting, and high fever

(2) is pregnant;

(3) does not respond to or cannot take oral medication and needs intravenous antibiotics;

(4) has an abscess in the fallopian tube or ovary (tubo-ovarian abscess).

(5)surgical emergencies (e.g., appendicitis) cannot be excluded;

If symptoms continue or if an abscess does not go away, surgery may be needed.

Complications of PID such as chronic pelvic pain and scarring improve with surgery.

How can PID be prevented?
--------------------------------

1. transmission of STDs can be prevented by abstainance from sexual intercourse,

2. a long-term mutually monogamous relationship with a partner who has been tested and is known to be uninfected can prevent STD.

3.Latex male condoms, when used consistently and correctly, can reduce the transmission of chlamydia and gonorrhea.

4.chlamydia testing of all sexually active women age 25 or younger and of older women with risk factors for chlamydial infections especially those with a new sex partner or multiple sex partners

5.Any genital symptoms such as an unusual sore, discharge with odor, burning during urination, or bleeding between menstrual cycles suggests a STD infection. Early treatment of STDs can prevent PID.

6. Intrauterine contraceptive devices containing levonorgestrel-and copper-containing devices may cause PID and should be removed if antibiotics does not cure the PID.

A Simple Guide to Bacterial Vaginosis

A Simple Guide to Bacterial Vaginosis
---------------------------------------------

What is bacterial vaginosis?
----------------------------------

Bacterial Vaginosis (BV) is a condition in women where the normal balance of lactobacillus bacteria in the vagina is disrupted and replaced by an overgrowth of high concentrations of anaerobic bacteria (e.g., Prevotella sp. , Mobiluncus sp.), G. vaginalis, and Mycoplasma hominis.
The condition is characterised by vaginal discharge, odor, pain and itching.
Bacterial Vaginosis is the most common vaginal infection in women after puberty.

How is bacterial vaginosis spread?
-------------------------------------------

BV is associated with an imbalance in the lactobacillus bacteria in a woman's vagina. The cause of this imbalance is not known.
Some possible causes of this imbalance are:

1.Having multiple sex partners or a new sex partner

2.Vaginal Douching which alter the pH and bacterial flora of vagina

3.Using an intrauterine device for preventing pregnancy.

Women that have never had sexual intercourse are rarely affected.

What are the symptoms of bacterial vaginosis?
-------------------------------------------------------

Women with typical Bacterial Vaginosis symptoms have:

1.an abnormal vaginal discharge with an unpleasant fish-like odor especially after intercourse.
The discharge is usually greyish, semiadherent, homogeneous.
Sometimes it can be thin,cream to green in colour and frothy.

2.burning sensation during urination

3.itching around the outside of the vagina,

More than 50% women with BV report no symptoms at all.

What are the complications of bacterial vaginosis?
-------------------------------------------------------------

In most cases, there are no complications.
Some serious complications from BV include:

1.pelvic inflammatory disease (PID) especially after surgery like hysterectomy
2.endometritis,

3.increased susceptibility to other STDs, such as chlamydia, gonorrhea and HIV.

4.increased risk for some complications of pregnancy such as ectopic pregnancy and premature births.

How is bacterial vaginosis diagnosed?
---------------------------------------------

1.vagina examination for homogeneous, thin, white discharge that smoothly coats the vaginal walls;

2.laboratory tests on a sample of vaginal fluid:

a.presence of clue cells on microscopic examination;

b.pH of vaginal fluid >4.5;

c.fishy odor of vaginal discharge before or after addition of 1% KOH (the whiff test).

d.Gram stain is used to detect the relative concentration of lactobacilli (long Gram-positive rods), Gram-negative and Gram-variable rods and cocci ( G. vaginalis, Prevotella, Porphyromonas, and peptostreptococci), and curved Gram-negative rods (Mobiluncus) characteristic of BV.

What is the treatment for bacterial vaginosis?
------------------------------------------------------

All women suspected of BV should be treated to avoid such complications as Pelvic Inflammatory Disease.
Treatment is especially important for pregnant women.
All pregnant women who have symptoms of BV should be checked and treated.

BV is treatable with antibiotics :
metronidazole 500 mg orally twice a day for 7 days
OR
Metronidazole gel, 0.75%,5 g intravaginally, once a day for 5 days
OR
Clindamycin 300 mg orally twice a day for 7 days
OR
Clindamycin cream, 2%,5 g intravaginally at bedtime for 7 days

Either can be used with non-pregnant or pregnant women, but the recommended dosages differ.
Patients treated with metronidazole should be advised to avoid consuming alcohol for 24 hours.
BV can recur after treatment.

How can bacterial vaginosis be prevented?
--------------------------------------------------

Since BV is seldom found in women who have never had intercourse.and is associated with having a new sex partner or having multiple sex partners, prevention measures are aimed at sexual transmission:

1. Abstain from sex

2.Do not have multiple sex partners.

3.Do not use vaginal douche.

4.Take all of the medicine prescribed for treatment of BV even if there are no more symptoms.

A Simple Guide to Measles

A Simple Guide to Measles
--------------------------------

What is Measles?
---------------------

Measles is usually a contagious childhood infection caused by the measles virus, one of the paromyxovirus.
It is characterised by typical prodromal symptoms, generalised rash and Koplik's spots in the mouth.

Who is at risk for Measles?
--------------------------------

Any one at any age can contract measles but it usually occurs in childhood.
Spread is usually by infected persons either from mucous discharges from their coughing and sneezing, or from contact with their skin rash,contaminated items and surfaces.
Usually a person is contagious for about two days before symptoms appear, and up to five days after appearance of the rash.


What are the Symptoms of Measles?
-------------------------------------------

There is a prodromal peroid of 5 to 7 days after contact with a infected person.
Early symptoms include:
1.high fever

2.coughing,

3.runny nose, stuffy nose,

4.tiredness,

5.red eyes, tearing. ,

6.Koplik's spots (white spots with a red background , located on the inside of the cheeks near the back molars start to appear 2-4 days after the fever.

7.measles rash usually occurs after the appearance of the Koplik's spots.
The rash is typically red,maculopapular, and starts from behind the ears and face, then spreads downward to the neck, trunk, limbs, and soles. Once it reaches the soles, the rash begins to fade in about four days , first the head and neck, then trunk and limbs. There may be a brownish discoloration in areas of affected skin rashes but this is only temporary.

8. enlarged lymph glands may be felt in the neck and groins

9.inflammation of the eyes (conjunctivitis) with tearing may also occurs.

10. diarrhoea and vomiting may occurs in some patients.

Adults tend to suffer more severe symptoms than children do.

People who have had measles develop a natural immunity and cannot contract it again.

What are the Complications of Measles?
------------------------------------------------

1.Ear infection (Otitis Media) is a common complication of measles.

2.pneumonia in very young children and older patients may be dangerous.

3.encephalitis (brain infection)may ocur in 1 out of 600 patients putting them at risk of suffering seizures, coma or dying.

4.the digestive organs (including the liver),the heart muscle or the kidneys may be damaged in rare cases

A pregnant woman who develops a measles infection has
1.an increased risk of premature labour,

2.miscarriage

3.delivery of a low birth weight baby.

What is the Treatment for Measles?
------------------------------------------

There is no cure for measles.
Treatment is therefore symptomatic.
Fever symptoms are treated with Paracetamol.
Children should not be given aspirin due to the risk of Reye's Syndrome which affects the brain

Itch may be controlled by antihistamines which can also help to relieve the runny nose.

Antibiotics may be given if there is superimposed secondary bacterial infection such as otitis emdia and pneumonia.

Cough mixtures may be given to relieve the cough.

Plenty of bed rest is necessary.

Lots of fluids helps to prevent dehydration.

A cool-mist humidifier to soothe respiratory passages may help.

Most patients recover completely from measles.

Death is extremely rare (one out of every 1000 cases), usually from pneumonia or encephalitis.

How do You prevent Measles?
-------------------------------------

Measles can be prevented with the measles vaccine, which is usually given to children at the age of 15 months as part of the MMR (measles, mumps and rubella) combination.

A second MMR vaccine is now given at the age of 12 years.

A Simple Guide to Hepatitis C

A Simple Guide to Hepatitis C
-----------------------------------

What is Hepatitis C?
------------------------

Hepatitis C is a serious inflammatory liver disease caused by a virus which is called hepatitis C virus (HCV).

Who is at risk of Hepatitis C?
-----------------------------------

Hepatitis C virus infection is one of the most common chronic bloodborne infection.
Persons at risk for infection are:

1. injection-drug users

2. blood transfusions or solid organ transplant recipients before July 1992

3. on long-term dialysis

4. sexual exposure to infected HCV carriers(rare)

What are the symptoms of Hepatitis C?
-----------------------------------------------

Persons who has been newly infected with HCV usually are asymptomatic or have a mild clinical illness:

1.mild fever and bodyaches

2.slight jaundice

3.nausea

4.enlarged liver

How do you diagnose Hepatitis C?
----------------------------------------

A person exposed to Hepatitis C infection can detect HCV RNA in blood within 1-3 weeks.
The time from exposure to antibody to HCV seroconversion(or Anti-HCV) is 8-9 weeks.
Therefore diagnosis can usually be confirmed by :

1.the presence of Anti-HCV in 98% of infected persons within 6 months of exposure.

2.Reverse transcriptase polymerase chain reaction to detect HCV RNA

Chronic HCV infection occurs in 70% of HCV-infected persons.

Two thirds of these have evidence of active liver disease but may not be aware of their infection because they are not clinically ill.

Infected HCV carriers can transmit the illness to others and develop chronic liver diseases for years after infection.

What is the treatment of Hepatitis C?
--------------------------------------------

There is no cure for HCV infections.
Persons found to be anti-HCV positive should be evaluated for presence of
1.active infection,

2.presence or development of Chronic Liver Disease,

3.for possible treatment of HCV.

Combination therapy with interferon and ribavirin may help in treatment of patients with chronic hepatitis C.

What is the Prevention for Hepatitis C?
----------------------------------------------

No vaccine for hepatitis C is available.

Immune globulin is not effective in preventing HCV infection after exposure.

Primary prevention is to reduce or eliminate HCV transmission.

Secondary prevention activities is to reduce liver and other chronic diseases in HCV-infected persons by identifying them and providing appropriate medical management and antiviral therapy.

Persons who test positive for anti-HCV should be provided information regarding

1) how to protect their liver from further harm by avoiding alcohol and taking any new medicines (including OTC and herbals)

2) how to prevent transmission to others
a) not donate blood, body organs, other tissue, or semen;

b) not share any personal items that might have blood on them (e.g., toothbrushes and razors);

c) cover cuts and sores on the skin to keep from spreading infectious blood or secretions

3) the need for medical evaluation including assessment of liver function tests, assessment for severity of liver disease and possible treatment, and determination of the need for hepatitis A and B.

HCV-positive women do not need to avoid pregnancy or breastfeeding.

Regardless of test results, persons who use or inject illegal drugs should be counseled to
1.stop using and injecting drugs;

2.enter a program to eradicate complete substance abuse treatment, including relapse prevention;

3.take the following steps to reduce personal and public health risks, if they continue to inject drugs:

4.never reuse or share syringes, water, or drug preparation equipment;

5. use only syringes obtained from a reliable source (e.g., pharmacies);

6.use a new, sterile syringe to prepare and inject drugs;

7.get vaccinated for hepatitis A and B.

A Simple Guide to Lice

A Simple Guide to Lice
---------------------------

What is Lice?
------------------

Lice is a parasite called Pediculosis which can live on your skin.

Whare are the locations of Lice?
-------------------------------------

It can occur at the
1. head or Pediculosis Capitis and

2..body or Pediculosis corporis.

3. pubis or Pediculosis Pubis

Pediculosis Capitis
-----------------------

Pediculosis Capitis (hair lice) causes itchiness of the scalp and produce nits(small ovoid eggs) on the hair shafts.
It is spread by personal contact, combs, hats, caps.
The incidence is high in school children and people with long hair.

Pediculosis corporis
------------------------

Pediculosis corporis (body lice) also causes itchiness of the skin of the body.
It is also spread by personal contact, clothing and is associated with poor personal hygience.

Pediculosis Pubis
---------------------

Pediculosis pubis (pubic lice) usually cause itchiness of the pubic area.
There may be lice or nits on their anogenital hair.
Pediculosis pubis is usually spread by sexual contact.

What are the symptoms of Lice?
--------------------------------------

1. Itchiness of the skin with scratch marks

2. Small red bites.

3. Excoriation of the skin

4. Nits on scalp and pubic hairs

5. Urticaria

6. bacterial infections at sites of bites.

7. lice and eggs sometimes seen on underwear or clothing.

How do you diagnose Lice?
-------------------------------

The lice and nits can be seen with a magnifying glass.

What is the treatment of Lice?
------------------------------------------

There are various topical medications used to treat lice:

Benzyl Benzoate lotion applied to affected areas and washed off after 30 minutes

Permethrin 1% cream rinse applied to affected areas and washed off after 10 minutes

Malathion 0.5% lotion applied for 12 hours and washed off
Resistance to pediculcides is widespread and increasing.

Nits should be removed with a fine comb.

Bedding and clothing should be machine-washed, machine-dried using the heat cycle, and allowed to dry in the sun.

Patients should avoid sexual contact with their sex partner until all have been treated.

All family members should be treated in order to eradicate the lice.

A Simple Guide to Syphilis

A Simple Guide to Syphilis
--------------------------------

What is Syphilis?
----------------------

Syphilis is a infectious sexually transmitted disease caused by the bacterium Treponema pallidum.
It can be acute, subacute or chronic depending on the stage.

How is Syphilis spread?
----------------------------

Syphilis is passed from a infected person through sexual contact with a infected sore which occur mainly on the external genitals, anus, or rectum.
The lips and the mouth may also have sores.

The bacteria can penetrate through normal mucous membrane and minor abrasions of the epithelium.
Transmission of the organism usually occurs during sexual contact.
Pregnant women with the disease can pass it to the babies they are carrying.

What are the symptoms of Syphilis?
--------------------------------------------

The signs and symptoms of syphilis may occur in four stages:

Primary
----------
These signs may occur from 10 to 90 days after exposure:

1.A small, firm, painless sore (chancre) appears on the body where the syphilis enter the body, usually the genitals, rectum, or lips.
A single chancre is typical, but there may be multiple sores.

2.Enlarged lymph nodes in your groin.

The chancre lasts 3 to 6 weeks, and it heals without treatment.
However, if untreated, the infection progresses to the secondary stage.

Secondary
----------
The signs and symptoms of secondary syphilis may begin two to 10 weeks after the chancre appears, and may include:

1.Rash marked by red or reddish-brown sores over any area of the body especially the palms and soles. The rash usually does not cause itching.

2.Fever

3.Fatigue and a vague feeling of discomfort

4.swollen lymph glands,

5.sore throat,

6.weight loss,

7.Soreness and aching

The signs and symptoms of secondary syphilis will resolve with or without treatment.
Without treatment, the infection will progress to the latent and late stages of disease.

Latent
--------

A period called latent syphilis in which no symptoms are present may follow the secondary stage.
Signs and symptoms may not appear until the disease may progress to the tertiary stage.

Tertiary
----------

Without treatment, syphilis bacteria may spread, leading to serious internal organ damage including the brain, nerves, eyes, heart, blood vessels, liver, bones,joints and finally death years after the original infection.

1.Neurological problems. These may include stroke; infection and inflammation of the membranes and fluid surrounding the brain and spinal cord (meningitis); poor muscle coordination; numbness; paralysis; deafness or visual problems; personality changes; and dementia.

2.Cardiovascular problems. These may include bulging (aneurysm) and inflammation of the aorta and of other blood vessels.
Syphilis may also cause valvular heart disease, such as aortic valve insufficiency.

Many people infected with syphilis do not have any symptoms for years, yet remain at risk for late complications if they are not treated.

What is the danger of Syphilis during pregnancy?
----------------------------------------------------------

The syphilis bacterium can infect the baby of a woman during her pregnancy. Depending on how long a pregnant woman has been infected, she may have a high risk of having a stillbirth or of giving birth to a baby who dies shortly after birth.
An infected baby may be born without signs or symptoms of disease.
Untreated babies may become developmentally delayed, have seizures, or die.

How do you diagnose Syphilis?
---------------------------------------

1. dark-field microscope: examining material from a chancre using this microscope.
If syphilis bacteria are present in the sore, they will show up when observed through the microscope.

2.A blood test for syphilis antibodies is accurate, safe, and inexpensive. There will be some antibodies in the blood for months even when the disease has been successfully treated.

Because untreated syphilis in a pregnant woman can infect and possibly kill her developing baby, every pregnant woman should have a blood test for syphilis.

What is the treatment of Syphilis?
-----------------------------------------

Syphilis is easy to cure in its early stages.

Treatment with intramuscular injection of penicillin can kill the organism that causes syphilis.
If you're allergic to penicillin, other antibiotics such as erythromycin will kill the syphilis bacterium.
Treatment however will not repair damage already done.
Left untreated, the disease can lead to serious complications or death.

Persons who receive syphilis treatment must abstain from sexual contact with new partners until the syphilis sores are completely healed.
Persons with syphilis must notify their sex partners so that they also can be tested and receive treatment if necessary.

Even if you were treated for syphilis during your pregnancy, your newborn child should receive antibiotic treatment.

To make sure you're responding to the usual dosage of penicillin, the doctor likely will want you to have periodic blood tests.
Blood test may remain positive up to 18 months even after successful treatment of syphilis.

Having syphilis once does not protect a person from getting it again. Following successful treatment, people can still be susceptible to re-infection.

How do you prevent Syphilis?
---------------------------

The surest way to avoid transmission of sexually transmitted diseases, including syphilis, is to 1.abstain from sexual contact

2.in a long-term mutually monogamous relationship with a partner who has been tested and is known to be uninfected.

3.Avoiding alcohol and drug use may also help prevent transmission of syphilis because these activities may lead to risky sexual behavior.

4.Correct and consistent use of latex condoms can reduce the risk of syphilis only when the infected area or site of potential exposure is protected.

5.Complications from syphilis such as neurosyphilis are rare because of better diagnosis and treatment

A Simple Guide to Candidiasis

A Simple Guide to Candidiasis
------------------------------------

What is Candidiasis ?
-------------------------

Candidiasis is caused usually by the fungus Candida albicans.
Other Candida species or yeasts are also responsible.

What are the causes of Candidiasis ?
-------------------------------------------

1. Broad spectrum Antibiotic therapy kills off normal bacterial flora, resulting in invasion of fungi or yeasts
2. Diabetes mellitus - the high sugar content in the blood and vagina lining are conducive to fungal or yeast infection
3. Steroid or immunosuppressive drugs suppress the immune response to bacterial and fungal infection.

What is the symptoms of Candidiasis ?
----------------------------------------------

30% of patients do not have any symptoms.
The rest have symptoms like:
1. pruritus,

2.vaginal soreness,

3.dyspareunia,

4.external dysuria, and

5.abnormal white transparent vaginal discharge with heavy odour.

About 75% of women will have at least one episode of Candidiasis, and 45% may have two or more episodes.

How do you diagnose Candidiasis ?
------------------------------------------

A diagnosis of Candida vaginitis is made clinically by the presence of:
1.external dysuria

2.vulvar pruritis, pain, swelling, and redness.

3. vulvar edema, fissures, excoriations,

4.thick curdy vaginal discharge.

The diagnosis is confirmed by
1) a Gram stain of vaginal discharge showing the presence of yeasts
2) a vaginal swab for culture shows the presence of a yeast species.

What is the treatment of Candidiasis ?
---------------------------------------------

Short-course intravaginal antifungal pessaries effectively treat uncomplicated Candidiasis .
The topically applied imidazole drugs are more effective than nystatin.
90% of patients are usually cured.

Oral Agent such as Fluconazole 150 mg may be given in one tablet in single dose.

Patients should be instructed to return for follow-up visits only if symptoms persist.

Candidiasis is not usually acquired through sexual intercourse.

A minority of male sex partners might have balanitis, which is characterized by itchy red areas on the glans of the penis.
These men benefit from treatment with topical antifungal agents to relieve symptoms.

Topical agents usually do cause any systemic side effects although in some people local burning or irritation might occur.
Oral agents sometimes cause nausea, abdominal pain, and headache.
Some abnormal elevations of liver enzymes may occur with treatment with the oral azoles.

What are the complications of Candidiasis?
---------------------------------------------------

1.Recurring Candidiasis:A small percentage of women (<5%)>.
The majority of women with recurring Candidiasis have no apparent predisposing or underlying conditions.
Vaginal cultures should be obtained from these patients to confirm the clinical diagnosis and to identify unusual species, including nonalbicans species, particularly Candida glabrata
Conventional antimycotic therapies are not as effective against these species as against C. albicans.

A longer duration of initial therapy is necessary to attempt mycologic remission before initiating a maintenance antifungal regimen:

Oral fluconazole (i.e., 100-mg, 150-mg, or 200-mg dose) weekly for 6 months
topical clotrimazole 200 mg twice a week,
clotrimazole (500-mg dose vaginal pessaries once weekly)

2.Women with underlying debilitating medical conditions (e.g., uncontrolled diabetes or on corticosteroid treatment) do not respond as well to short-term therapies.
The underlying diseases should be treated and more prolonged (i.e., 7–14 days) conventional antimycotic treatment is necessary.

3.During pregnancy, Candidiasis is quite common.
Only topical azole therapies, applied for 7 days, are recommended for use .
Oral treatment is contraindicated because of risks of deformity in the foetus.

A Simple Guide to Myasthenia Gravis

A Simple Guide to Myasthenia Gravis
--------------------------------------------

What is myasthenia gravis?
----------------------------------

Myasthenia gravis is a rare chronic autoimmune neuromuscular disease that cause weakening of the skeletal muscles of the body.
The name myasthenia gravis literally means grave muscle weakness.

What causes myasthenia gravis?
--------------------------------------

Myasthenia gravis interferes in the transmission of nerve impulses to muscles. Normally the nerve endings release a neurotransmitter substance called acetylcholine which then travels to the neuromuscular junction. The aceylcholine binds to acetylcholine receptors which are activated and generate a muscle contraction.

In myasthenia gravis, these antibodies block, modify, or destroy the receptors for acetylcholine at the neuromuscular junction and prevents muscle contraction.

In myasthenia gravis, the thymus gland which is responsible for the production of the immune cells is abnormal.
The thymus gland may give incorrect instructions to developing immune cells, ultimately resulting in the production of the acetylcholine receptor antibodies.

Who is at risk of myasthenia gravis?
-------------------------------------------

Myasthenia gravis occurs at any age usually at age 30-40 in women and 50-60 in men. It occurs more in women than in men.
In rare cases, the foetus may acquire antibodies from a mother affected with myasthenia gravis. Cases of neonatal myasthenia gravis are temporary and the child's symptoms usually disappear within 2-3 months after birth.

Myasthenia gravis is not directly inherited.
Rarely, the disease may occur in more than one member of the same family.

What are the symptoms of myasthenia gravis?
------------------------------------------------------

The typical feature of myasthenia gravis is muscle weakness that increases during periods of activity and improves after periods of rest.

The onset of the disorder is usually sudden.

The weakness may affect any voluntary muscle, muscles which control eye and eyelid movement, facial expression, talking, and swallowing,muscles that control breathing, neck and limb movements:
1.weakness of the eye muscles,a drooping of one or both eyelids (ptosis)2.difficulty in swallowing
3.slurred speech
4.blurred or double vision (diplopia) due to weakness of the muscles controlling eye movements,
5.unstable or waddling gait,
6.weakness in arms, hands, fingers, legs, and neck,
7.a change in facial expression,
8.shortness of breath
9.fatigue

How is the diagnosis of myasthenia gravis made?
----------------------------------------------------------

The diagnosis of myasthenia gravis involve
1.a complete medical history,

2.physical and neurological examinations,especially for impairment of eye movements or muscle weakness without loss of sensation.

3.blood test to detect the presence of acetylcholine receptor antibodies which are abnormally raised in most patients.

4.the edrophonium response test which requires the intravenous administration of edrophonium chloride or Tensilon(r), a drug that blocks the breakdown of acetylcholine and temporarily increases the levels of acetylcholine at the neuromuscular junction. In people with myasthenia gravis, edrophonium chloride will briefly relieve weakness.

5. Electromyographic studies where repetitive nerve stimulation records weakening muscle responses.

6.Computed tomography may be used to identify an abnormal thymus gland or the presence of a thymoma.

7.pulmonary function testing helps to detect abnormal respiratory function which may fail and lead to a myasthenic crisis.

8.A curare test is now rarely done

How is the treatment for myasthenia gravis ?
-----------------------------------------------------

Treatment for myasthenia gravis has improved tremendously with several therapies to help reduce and improve muscle weakness.

1.anticholinesterase agents such as neostigmine and pyridostigmine, which help improve neuromuscular transmission and increase muscle strength.

2.Immunosuppressive drugs such as prednisone, cyclosporine, and azathioprine improve muscle strength by suppressing the production of abnormal antibodies. They must be used cautiously because of their many side effects.

3.Thymectomy, the surgical removal of the thymus gland (usually abnormal in myasthenia gravis), reduces symptoms in more than 70 percent of patients and may cure some individuals, possibly by re-balancing the immune system.

4.plasmapheresis in which abnormal antibodies are removed from the blood, and high-dose intravenous immune globulin, which temporarily modifies the immune system and provides the body with normal antibodies from donated blood.

What are myasthenic crises?
----------------------------------

A myasthenic crisis occurs when the muscles that control breathing weaken to the point that brathing is difficult and requires a respirator for assisted ventilation. It may be triggered by infection, fever, or an adverse reaction to medication.

This condition requires immediate medical attention.

What is the prognosis for myasthenia gravis?
------------------------------------------------------

1.With all these new treatments the prognosis for most patients with myasthenia gravis is good.

2.Many of them will have significant improvement of their muscle weakness.

3.Some cases of myasthenia gravis can go into remission to the extent that medications can be discontinued.

4.Thymectomy hsve resulted in many complete remissions.

5.Life expectancy is not lessened by the disorder.

A Simple Guide to Trichomoniasis

A Simple Guide to Trichomoniasis
-----------------------------------------

What is Trichomoniasis?
-------------------------------

Trichomoniasis is a common curable sexually transmitted disease caused by the single-celled protozoan parasite, Trichomonas vaginalis.

How is Trichomoniasis spread?
------------------------------------

The parasite is sexually transmitted through penis-to-vagina intercourse with an infected partner.
In women, the vagina is the most common site of infection.
In men the urethra is the most common site of infection.
Women can contract the disease from infected men or women.
Men usually contract it only from infected women.

What are the symptoms of Trichomoniasis?
----------------------------------------------------

Most men with trichomoniasis are symptomless.
Some men may temporarily have an irritation inside the penis, mild discharge, or slight burning after urination or ejaculation.

Women have symptoms of infection which consists of a frothy, yellow-green vaginal discharge with a strong fishy smell.
There may be discomfort during intercourse and urination and irritation and itching of the female genital area.
Cystitis and urethritis can also occur with increased frequency and pain during urination.
Rarely lower abdominal pain can occur.

Pregnant women with trichomoniasis may have babies who are born early or with low birth weight.

How do you diagnose Trichomoniasis?
------------------------------------------------

A physical examination and laboratory test is needed to diagnose trichomoniasis.
The parasite is harder to detect in men than in women.
In women, a pelvic examination can reveal small red ulcerations on the vaginal wall or cervix.
A Pap smear may sometimes show the presence of the trichomonas protozoa.

What is the treatment of Trichomoniasis?
---------------------------------------------------

Trichomoniasis can usually be cured with the prescription drug, metronidazole, given by mouth in a single dose or daily for one week.
It is important for the patient to avoid alcohol with metronidazole and abstain form sex until they and their sex partners complete their treatment and have no symptoms.
Once treated the infection can be cured.

It is important therefore that both partners should be treated at the same time to eliminate the parasite.

Metronidazole can be used to treat pregnant women.
Having trichomoniasis once does not protect a person from getting it again. Following successful treatment, people can still be susceptible to re-infection.

How do you prevent Trichomoniasis?
---------------------------------------------

The surest way to avoid transmission of sexually transmitted diseases is to abstain from sexual contact.

A long-term mutually monogamous relationship with a partner who has been tested and is known to be uninfected is important.

Latex male condoms, when used consistently and correctly, can reduce the risk of transmission of trichomoniasis.

A person diagnosed with trichomoniasis (or any other STD) should receive treatment and should notify all recent sex partners so that they can be treated. This reduces the risk that the sex partners will develop complications from trichomoniasis and reduces the risk that the person with trichomoniasis will become re-infected.

Sex should be stopped until the person with trichomoniasis and all of his or her recent partners complete treatment for trichomoniasis and have no symptoms.

There is no vaccine for Trichomoniasis.

A Simple Guide to Human papilloma virus Infection

A Simple Guide to Human papilloma virus Infection
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What is Human papilloma virus Infection ?
----------------------------------------------------

Human papilloma virus infection is a sexually transmitted disease that is caused by human papilloma virus (HPV).
Human papilloma virus includes more than 100 different strains.
About 30 of these viruses are sexually transmitted.
They can infect the penis, vulva, anus in men, and the linings of the vagina, cervix, or rectum in women.

Some of these viruses may also cause cancer of the cervix, vulva, vagina, anus, or penis.

How is Human papilloma virus spread?
-----------------------------------------------

The types of HPV that infect the genital area are spread primarily through sexual contact.
Because most HPV infections have no signs or symptoms, many infected persons are unaware they are infected and may transmit the virus to a sex partner.

Very rarely, a pregnant woman can pass HPV to her baby during vaginal delivery. If that happens, the baby usually develops warts in the throat.

What are the Symptoms of Human papilloma virus infection?
-------------------------------------------------------------------------

Most people who have a genital HPV infection do not know they are infected.
The virus lives in the skin or mucous membranes and do not usually cause any symptoms.
Some people get visible genital warts in the vulva, vagina, cervix or rectum in women and on the penis, scrotum, or anus in men.

Genital warts are single or multiple growths or bumps that appear in the genital area, and sometimes are cauliflower shaped.

After sexual contact with an infected person, warts may appear within weeks or months, or not at all.

Some may cause pre-cancerous changes in the cervix, vulva, anus, or penis.
Very rarely, HPV infection results in anal or genital cancers.

How do you diagnose Human papilloma virus infection?
-------------------------------------------------------------------

Genital warts can be diagnosed by visual inspection especially in men.

Most women are diagnosed with HPV on the basis of abnormal Pap tests which can detect cervical cancer or pre-cancerous changes in the cervix.
Many of these changes are related to HPV.

There is also a specific test is available to detect HPV DNA in women.
The test may be used in women with mild Pap test abnormalities.

No HPV tests are available for men.

What is the treatment for Human papilloma virus infection?
-----------------------------------------------------------------------

There is no cure for HPV infection.

In most women the infection goes away on its own.
The treatments provided are directed to the warts and pre-cancerous changes in the cervix(Surgical coning of the cervix).

Visible genital warts can be removed by medications the patient applies such as Podophyllin,Imiquimod cream, 5-fluorouracil cream ,Trichloroacetic acid (TCA) .
Podophyllin and 5-fluorouracil cream should not be used in pregnant women because these may cause deformity in the baby.

Small warts can be removed by one of three methods.
Freezing (cryosurgery)
Burning (electrocautery)
Laser treatment

Large warts may require surgery.

Although the above treatments may remove the visible warts, the virus may still be in the body and recurrence may occur.

Sometimes the warts will disappear on their own.
If that happens, nothing else need to be done.

What are the complications of Human papilloma virus infection?
-----------------------------------------------------------------------------

All types of HPV can cause mild Pap test abnormalities which may not be serious.
In most cases (90 percent), cervical HPV infection in women becomes undetectable within two years.
Only a small proportion of women have persistent infection.
About 10 of the 30 identified genital HPV types can lead to the rare development of cervical cancer.


How do you prevent Human papilloma virus infection?
------------------------------------------------------------------

Education and counseling of persons at risk on ways to avoid STDs through changes in sexual behaviors:
1.The surest way to eliminate risk for genital HPV infection is to refrain from any sexual contact with another individual.

2.A long-term, mutually monogamous relationship with an uninfected partner is the prevention for future genital HPV infections.

3.The use of a latex condom has been associated with a lower rate of cervical cancer which is related to HPV disease.

4.Follow up is important in order to watch for recurrences which can occur most frequently during the first 3 months after treatment.
Pap smear screening of women every 3-6 months is important to check for recurrences.

5. preexposure vaccination of persons at risk for HPV infection.
The new vaccine Gardasil is effective against HPV types 16 and 18 which cause approximately 70% of cervical cancers, and against HPV types 6 and 11 which cause approximately 90% of genital warts.


Added 4th October 2008
-----------------------------------

The most common HPV types causing 70% of all cervical cancers are the HPV 16,18, 31 and 45.

Both new vaccines against HPV Cervarix and Gardasil are equally effective in producing high antibodies against HPV 16 and 18 and preventing these infections over a 5 year period.

However prevention of the HPV 16 and 18 does not mean the cervical cancer can be abolished totally.

A Simple Guide to Anthrax

A Simple Guide to Anthrax

--------------------------------

What is Anthrax?

---------------------

Anthrax is a disease caused by a gram positive spore forming bacterium that primarily infects mainly animals but can cause serious illness in humans if one is exposed to these spores.

It can affect the skin, the intestines or the lungs.

What are the different forms of Anthrax?

-----------------------------------------------

1.Cutaneous anthrax is the most common type of anthrax.

It occurs 1-2 days after the skin is scratched and exposed to soil, animal parts or faeces containing the spores of Anthrax.

The affected skin forms an itchy black swelling that becomes a blister that breaks into an ulcer.

The bacteria can then enter the bloodstream and cause septicaemia (blood poisoning). 20% of cases will die if they are not treated promptly.

2.Intestinal anthrax happens 2 to 5 days after one eats contaminated meat containing the spores.

The intestinal lining breaks and bleeding occurs. The victim feels nausea, loss of appetite, vomiting, fever and suffers from severe abdominal pain, bloody vomiting and diarrhoea.

Blood poisoning occurs and the loss of blood can result in shock.

25% to 75% of cases will eventually die.

3.Inhalation anthrax is the least common of the 3 types.

However it is the most serious form of anthrax because the spores are inhaled into the lungs.

Flu-like symptoms occur for 2 to 3 days with fever, cough and then breathlessness starts.

Then the lungs starts to bleed internally like a person drowning in his own blood. Death occurs rapidly most of the time.

This is the type that is used as a biological weapon by terrorists who will send the spores by envelopes to their victims.

What is the treatment of Anthrax?

-----------------------------------------

The bacterium is easily killed by several antibiotics(penicillin,tetracycline etc), the most effective one being ciprofloxacin given intravenously or directly into the bloodstream.

Oral ciprofloxacin is also effective in less severe cases.

There is no need to take antibiotics to prevent anthrax.

Doing so may cause the bacteria to become resistant to the antibiotic and make it more difficult to treat.

A cell-free vaccine has been developed for people who are at risk of contracting anthrax. This vaccine may be mass produced in the future for common use.

Although anthrax is a much feared disease, it can be prevented and treated with careful and alert practices.

Its use as a biological warfare agent is currently very limited with very effective counter measures in place.

A Simple Guide to Gonorrhea

A Simple Guide to Gonorrhea
-----------------------------------

What is Gonorrhea?
------------------------

Gonorrhea is a sexually transmitted disease caused by the gram negative bacteria Neisseria gonorrhoeae.

How is gonorrhea spread?
-----------------------------

Gonorrhea is a very common infectious disease, a bacterium that can grow and multiply easily in the warm, moist areas of the reproductive tract, including the cervix, uterus and fallopian tubes in women, and in the urethra in women and men.
The bacterium can also grow in the mouth, throat, eyes, and anus.

Gonorrhea is spread by infected people through contact with the penis, vagina, mouth, or anus.
There is no life long immunity after tratment with Gonorrhea.
A person who has been treated for gonorrhea may get infected again if there is sexual contact with a person infected with gonorrhea.
Gonorrhea can also be spread from mother to baby during delivery.

Who is at risk for gonorrhea?
-----------------------------------

Any sexually active person can be infected with gonorrhea if their partner has the disease.

What are the symptoms of gonorrhea?
---------------------------------------------

A high percentage of men with gonorrhea do not have any symptoms at all.
Some men have some symptoms that appear two to five days after infection.
Symptoms include
1.a burning sensation when urinating, or a white, yellow, or green discharge from the penis.

2. painful or swollen testicles.

In women the symptoms of gonorrhea are often mild.
Most women who are infected have no symptoms.
The initial symptoms in women include
1.a painful or burning sensation when urinating,

2.increased vaginal discharge,

3.vaginal bleeding between periods.

4.lower abdominal pain due to salpingitis(infected fallopian tubes)

Women with gonorrhea are at risk of developing serious complications from the infection.

Symptoms of rectal infection in both men and women may include discharge, anal itching, soreness, bleeding, or painful bowel movements.
Most of the time rectal infection do not cause symptoms.

Infections in the throat may cause a sore throat.
Usually there are no symptoms.

How does gonorrhea affect a pregnant woman and her baby?
-----------------------------------------------------------------------

A pregnant woman with gonorrhea may give the infection to her baby as the baby passes through the birth canal during delivery.
This can cause blindness, joint infection, or a life-threatening blood infection in the baby.
Treatment of gonorrhea should be started as soon as it is detected in pregnant women.

How is gonorrhea diagnosed?
-----------------------------------

There are several laboratory tests available to diagnose gonorrhea:

1. a swab may be taken from cervix, urethra, rectum, or throat for testing

2. A direct Gram smear test of a sample from a urethra or a cervix allows the doctor in the clinic to see the gonorrhea bacterium under a microscope.

3. blood test can also detect the presence of gonorrhea in the blood stream

What is the treatment for gonorrhea?
--------------------------------------------

There are several antibiotics(penicillin, tetracyclines, spectinomycin) which can successfully cure gonorrhea in adolescents and adults.

Drug-resistant strains of gonorrhea are increasing in many areas of the world and successful treatment of gonorrhea is becoming more difficult.

Sometimes people with gonorrhea also have chlamydia.
Antibiotics for both infections are usually given together.

Persons with gonorrhea should be tested for other STDs.

It is advisable to take all of the medication prescribed to cure gonorrhea.
People who have had gonorrhea and have been treated can get the disease a second time if they have sexual contact with persons infected with gonorrhea.

What are the complications of gonorrhea?
--------------------------------------------------

Untreated gonorrhea can cause serious and permanent complications in both women and men.
In women, gonorrhea is a common cause of pelvic inflammatory disease (PID).
Women with PID may not have symptoms.
Symptoms when present can be very severe and can include abdominal pain and fever.
PID can cause internal abscesses in the pelvis which can give rise to long-lasting, chronic pelvic pain.
PID can damage the fallopian tubes enough to cause infertility and the risk of ectopic pregnancy.
Ectopic pregnancy is a life-threatening condition in which a fertilized egg grows outside the uterus, usually in a fallopian tube, sometimes in the abdomen.

In men gonorrhea can cause epididymitis, a painful infection of the testicles that can lead to infertility if left untreated.
Prostatits(infection of prostate), seminal vesiculitis and chronic urethral infection may be associated with fever and lead to urethral strictures causing difficulty in passing urine.

People with gonorrhea are more likely to contract HIV the virus that causes AIDS.

Gonorrhea can spread to the blood, joints or eyes(uveitis).
Blood infection or septicemia can be life threatening.

How can gonorrhea be prevented?
-----------------------------------------

The best way to avoid transmission of sexually transmitted diseases is to abstain from sexual intercourse.
He or she should be in a long-term mutually monogamous relationship with a partner who has been tested and is known to be uninfected.

Latex condoms, when used consistently and correctly, can reduce the risk of transmission of gonorrhea.

Any genital symptoms such as discharge or burning sensation during urination or unusual sore or rash should be a signal to stop having sex.
A person who has been diagnosed and treated for gonorrhea should notify all recent sex partners so they can also be treated.
In this way there is less risk that the sexual partners will develop serious complications from gonorrhea.
It will also reduce the person's risk of becoming re-infected.
The person and all of his or her sex partners must avoid sex until they have completed their treatment for gonorrhea.

A Simple Guide to Cerebral aneurysm

A Simple Guide to Cerebral aneurysm

---------------------------------------------

What is Cerebral aneurysm?

-----------------------------------

A cerebral aneurysm is an abnormal ballooning of a section of a blood vessel in the brain.

What is the causes of cerebral aneurysm?

--------------------------------------------------

Cerebral aneurysms occur when there is a weakened area in the wall of a blood vessel in the brain.

1.They may occur as a congenital (before birth) defect or may develop later in life.

About 5% of the population has some form of aneurysm in the brain.

2.Trauma and infection, which can injure the blood vessel wall, can cause such aneurysms.

What are the Symptoms of cerebral aneurysm?

---------------------------------------------------------

Cerebral aneurysm usually cause no symptoms until they rupture and cause bleeding into the brain.

Often, an aneurysm is found when a CT scan or MRI is performed for another reason. If the unruptured swollen aneurysm presses on the brain , it can cause the following symptoms:
1.Headaches

2.Eye pain

3.Neck pain

4.Double vision

5.Loss of vision

Symptoms of an aneurysm that have ruptured are:
1.Sudden occurrence of a severe headache (often described as "worst headache of my life")

2.Headaches with nausea or vomiting

3.Stiff neck

4.Muscle weakness, difficulty moving any part of the body

5.Numbness or decreased sensation in any part of the body

6.Vision changes like blurring of vision,double vision

7.Eyelid drooping

8.Confusion,

9. Sudden onset of irritability, impulsivity, or poor temper control

10.Slow, sluggish movement

11.Speech impairment

12.Seizures

A ruptured aneurysm is a medical emergency.

What are the investigations done in cerebral aneurysm?

------------------------------------------------------------------

The following tests may be used to diagnose cerebral aneurysm:

1.CT scan of the head can identify bleeding and usually locate the aneurysm.

2.MRI of the head may be an alternative to a CT scan but may be as good at showing bleeding in the brain.

3.Cerebral angiography or spiral CT scan angiography of the head is used to pinpoint the location and size of the aneurysm.

4.cerebrospinal fluid examination via a spinal tap may confirm bleeding.

5.EEG (electroencephalogram) should be performed if there are seizures.

What is the Treatment of cerebral aneurysm?

--------------------------------------------------------

Symptoms often do not appear until bleeding of a cerebral aneurysm occurs.

A ruptured cerebral aneurysm is an emergency condition.

The goal of treatment is to prevent further bleeding.

Lowering of blood pressure can decrease the risk of further bleeding.

Neurosurgery is the primary treatment for cerebral aneurysm.

The base of the aneurysm is closed off with clamps or sutures.

Special coils or stents can be placed into the aneurysm through the arteries to prevent rupture.
A blood clot then forms in the aneurysm and prevents further bleeding. This is considered a less invasive approach than brain surgery. It is regarded as the best form of treatment.

If surgery is not feasible because of the location or size of the aneurysm or the condition of the person, medical treatment is:

1.restricting activity (often complete bedrest is advised),

2.treating symptoms such as headache,

3.controlling blood pressure, and

4.prescribing of antiseizure medications.

After the aneurysm is repaired, prevention of stroke due to blood vessel spasm is necessary. This may include intravenous fluids, certain medications, and controlling the blood pressure.

What is the Prognosis of cerebral aneurysm?

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The prognosis depends on the severity of the condition.
Ruptured cerebral aneurysms are often serious.

In severe cases, about 25% of people die within 1 day, and another 25% die within about 3 months. Of those who survive, more than half will have some sort of permanent disability.

In small leaks of ruptured cerebral aneurysm, early treatment of the condition can be very effective with little loss of neurological deficit.

Unruptured aneurysms can be treated very effectively before causing problems.

The decision to repair an unruptured cerebral aneurysm is based on the size and location of the aneurysm, and the patient's age and general health.

What are the Possible Complications of cerebral aneurysm?

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1.Subarachnoid hemorrhage

2.Stroke

3.Seizures, epilepsy

4.Paralysis of any part of the body

5.Permanent loss of sensation of any part of the face or body

6.Other neurologic deficits (such as vision changes, loss of speech ability, cognitive decline)

What is the Prevention of cerebral aneurysm?

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There is no known way to prevent the formation of a cerebral aneurysm because most of them are congenital.

If sudden or severe headache occurs, particularly if you also have nausea, vomiting, seizures, or any other neurological symptoms, early admission to hospital and appropriate investigation can detect an unruptured aneurym or one which has just started to bleed.

Treatment can be initiated and prognosis is good.