A Simple Guide to Stomatitis

A Simple Guide to Stomatitis
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What is Stomatitis?
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Stomatitis means inflammation of the mouth

What are the Causes of Stomatitis?
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There are many many disorders which can cause Stomatitis:

1.Bacteria, viruses, fungus

2.avitaminosis

3.leukemia,agranulocytosis

4.Dental problems,poor fitting denture, poor dental hygience

5.smoking

6.medicines: phenytoin, iodides, barbiturates

7.stress

What are the Symptoms of Stomatitis?
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Stomatitis usually appear on the inner surface of the cheeks and lips, tongue, soft palate, and the base of the gums.

It may begin with a tingling or burning sensation, followed by a red hyperemia of the inside of the lining of the cheek, gums or tongues.

The inflamed surfaces may develop into ulcers

Occasionally, a severe occurrence may be accompanied by fever,lymphadenopathy and lethargy.

Most mouth inflammation is not infectious except bacterial,fungal and viral infections.

Oral mucosal smears may be necessary to determine those with bacterial or fungal infections.

What is the Treatment of Stomatitis?
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The exact treatment will depend on the cause of the Stomatitis.
Sometimes all that is required is to remove the cause of the Stomatitis such as an ill fitting denture.

The following measures may help to reduce pain from Stomatitis:
Proper oral hygience:
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1.keep your mouth clean at all times,

2.avoid foods that are spicy, acidic, salty or particularly hot or cold, which can make the symptoms worse,

3.eat a healthy diet that includes fresh fruit and vegetables,

4.gargle with warm salt water,

5.use a diluted chlorhexidine mouthwash once a day to help reduce the length of time the stomatitis last.

6.sprays and rinses are also available for pain relief.

Medical treatment:
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The main treatment of the Stomatitis is application of topical corticosteroids (Kenalog in orabase or Oracorte E), or other soothing preparations.

Where bacteria are present the appropriate antibiotic will treat the Stomatitis.

Antifungal agents are used to treat fungal infection.

Vitamin B replacements are important in cases due to deficiency of the vitamins.

Underlying condition:
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Treatment of systemic condition causing the Stomatitis such as leukemia,

What are the Prevention measures in Stomatitis?
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Good oral hygiene may help in the prevention of some types of stomatitis or complications from stomatitis.

This includes brushing the teeth at least twice per day, flossing at least daily, and going for regular dental checkup and cleaning.

Try to avoid getting run down by making sure you eat a balanced diet, take regular exercise and learn to manage stress.

What is the prognosis of the Stomatitis?
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The outlook for most stomatitis is good.

Those with underlying condition such as leukemia will improve with treatment of the illness.

A Simple Guide to Cystitis

A Simple Guide to Cystitis
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What is Cystitis?
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Cystitis is an acute or chronic infection of the urinary bladder.

What are the causes of Cystitis?
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Cystitis is usually caused by the following:

1. ascending infection of the urinary bladder from the urethra.

2. in females frequently associated with sexual activity eg. honeymoon cystitis

3.In males with enlargement of the prostate or infection of the prostate

4. In children, the bacteria E.coli of the same type as the child's bowels

5.More frequently present in Diabetic patients

6.procedures such as urinary catheterisation

7.cystitis is more common in the female,especially those on contraceptive pills or with intrauterine contraceptive devices.

8. may be associated with congenital abnormalities of the urinary tract such as bladder neck obstruction,urethral reflux,neurogenic bladder,and urinary incontinence.

What are the symptoms and signs of Cystitis?
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Persons who has Acute Cystitis has the following symptoms:

1.frequency of urination and nocturia

2.painful urination

3.suprapubic discomfort

4.cloudy and unpleasant smelling urine, sometimes blood in the urine

5.fever and chills especially in children

Signs:
Tenderness on palpation in the suprapubic region

How do you diagnose Cystitis?
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Diagnosis can usually be made by :

1.History of frequency of urination, painful urination

2.Urine test shows the presence of pus cells, leucocyte, red blood cells and micro-organisms

3.Urine culture will determine the micro-organism involved and the antibiotic most appropriate for it.

4. cystoscopy may be necessary to exclude tumours of the bladder

What are the complications of Cystitis?
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Upward infections from the bladder can lead to infections of the kidneys and kidney failure.

What is the treatment of Cystitis?
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Analgesic or antispasmodic medicine

Antibiotics for infections especially after urine bacterial culture

Lots of fluids

What is the prognosis of Cystitis?
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Prognosis is usually good with medication.

Recurrence is quite common.

cystitis,frequency,painful,nocturia,sexual activity,antibiotics,analgesic, cystoscopy, urine test, bacteria culture,prostate

A Simple Guide to Cholera

A Simple Guide to Cholera
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What is Cholera?
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Cholera is an acute infectious illness caused by the Vibrio cholorae bacteria.

What is the cause of Cholera?
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The bacteria which causes Cholera is the Vibrio cholorae which is an extremely hardy bacteria able to live in polluted water and contaminated food.

There are 2 main types of cholera bacteria:

1.the Classic short slightly curved Gram negative aerobic rods

2.The El Tor strain which is hardier,persists longer in nature and is more likely to cause carrier states in humans.

Incubation period is 12 hours to 6 days.

What are symptoms of Cholera?
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The main symptoms of Cholera are

1. Vomiting after 12 hours of ingestion of bacteria

2. abrupt painless rice water diarrhoea

3. abdominal pain

4. prostration and muscle cramps

Severe cases may have dehydration leading to:

1.hypotension

2.cardiovascular collapse

3.tachycardia

4.difficulty in breathing and cyanosis

5.weak peripheral pulses

6.delirium and disorientation

7.lassitude and tiredness

8.convulsions in small children

Symptoms usually appear within 12 hours after exposure to the germ and last up to 1 week.

How is Cholera transmitted?
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Most epidemics are water borne espcially after severe flooding.
The germs can also be transmitted by food handlers.

How is the diagnosis of Cholera made?
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Doctors generally diagnose Cholera based on the symptoms and a physical examination.
Confirmation is by blood tests and stool cultures.

What are the complications of Cholera?
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Cholera is a disease which can kill espcially through its complications:

1.Severe dehydration especially in young children and the very old patients

2.Hypovolemic shock

3.uncompensated metabolic acidosis

4.renal failure

How is Cholera treated?
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Cholera is an infectious disease which can spread to other people through contaminated food and water.
It is therefore advisable to quarantine the patient in hospitals.

1.The most important complication in Cholera is dehydration so prompt replacement of fluids and electrolytes intravenously is necessary.

WHO diarrhea treatment solution consists of
a.4gms of sodium chloride
b.6.5gms of sodium acetate
c.1 gm of potassium chloride
d.10gms of glucose
in 1 liter of sterile distilled water.

Where intravenous administration of diarrhea solution is not available, isotonic drinks and even coconut water may act as replacements.

2. Careful monitoring of the patient as 1 liter of fluid may be lost in the stools in one hour.

3.Antibiotics is the main treatment against cholera.
The best antibiotic is tetracycline or deoxycline.

Symptomatic treatment includes:

1.Paracetamol for relief of fever and headache

2.antispasmodic drug to stop abdominal cramps

3.medicine to harden the stools such as kaolin

4.slow down the intestinal movement (lomotil or loperamide).

Gradually reintroduce food, starting with bland, easy-to-digest food, like porridge or soups.

Get plenty of rest.

How is Cholera prevented?
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Prevention of Cholera can be by vaccination with the cholera vaccine.
However the success rate of immunisation against Cholera is only 20-30% so most doctors do not recommended it.

You can avoid infection by:
Avoid eating or drinking foods or liquids that might be contaminated
Good food hygience

What is the prognosis of Cholera?
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Prognosis is excellent with prompt treatment of rehydration treatment.
After replacement symptoms usually clear within 48 hours with tetracycline treatment.

A Simple Guide to Cervical Spondylosis

A Simple Guide to Cervical Spondylosis
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What is Cervical Spondylosis?
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Cervical Spondylosis is a degenerative disease of the joints of the cervical spine(neck), causing pain in the neck and nerve root irritation.

Who get Cervical Spondylosis?
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Every one can get Cervical Spondylosis.
The age of onset is usually in the late 40 or early 50.
It is also more common in men than women.
It is worst in the lower cervical spine.

What are the causes of Cervical Spondylosis?
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The causes of Cervical Spondylosis are:

1.Age Degeneration of the cervical spine due to usage such as bending the head to read or write.
The weight of the skull also serves to compress the vertebrae of the cervical spine as well as the intervertebral discs causing narrowing of disc space and bone protrusions called osteophytes which becomes worse with age.

2.Trauma and injury such as whip lash injury, head injuries can also indirectly injure the vertebra of the neck and cause intervertebral disc protrusions.

3. Congenital abnormality of the cervical spine such as incomplete formation of the vertebra and disc.

What are the Symptoms of Cervical Spondylosis?
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1.The onset is usually gradual with occasional neck pain over weeks or months.

2.There may be a history of trauma to the neck or prolonged neck strain.

3.Early morning neck stiffness and pain may occur,then wears off during the day.

4.The pain may radiate to the shoulder or upper limb.
Pain can be persistent in some cases.

5.Numbness, paresthesia even weakness of the arm and hands may occur due to compression of the neck nerve root.

6.Headaches may be common due to pressure on the neck muscles giving rise to pain to the occiptal region.

7.Neck movements may be restricted in all directions. There may be creaking sounds of the neck on movement.

8.Muscle weakness of the upper and/or lower limb with muscle wasting

Pain may be aggravated by stress, poor general health, prolonged period of the neck in one position.

How is Cervical Spondylosis diagnosed?
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Confirmation is usually by an xray of the cervical spine which may show:
Typical cervical vertebra degeneration,
Disc space narrowing
Osteophytic changes
Narrowing of the exit foramina
Subluxations of the vertebra
Sclerosis of the vertebral margins
Lordosis of the spine

How to treat Cervical Spondylosis?
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Not every patient suffer the same degree of symptoms

1. mild requiring only exercises or mild pain killers.

2. more severe require:

a.Neck collars

b.physiotherapy -cervical traction, shortwave diathermy, neck exercises

c.NSAIDs painkillers

d.surgery for cord compression,intractable root symptoms,vertebral artery compression,weakness of arms or legs

3. All cases require:

protection of neck from muscle strain

avoidance of excessive bending and turning of neck

maintenance of good posture

avoidance of emotional stress

What is the prognosis of Cervical Spondylosis?
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Symptoms comes and go.

With exercise and NSAIDS, pain is reduced and flexibility of the spine is improved especially with regular exercise and proper posture.

Injury and stress can aggravate the condition.

There is no cure.

A Simple Guide to Urticaria

A Simple Guide to Urticaria
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What is Urticaria?
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Urticaria is an itchy rash that occurs rapidly anywhere on the body.
The rash may occur often simultaneously at multiple sites.
It is usually temporary disappearing after 24 hours although new rashes may occur at other sites.

What causes Urticaria?
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Urticaria is usually due to known mast cell stimulants although in the majority of cases the cause is unknown.


Urticaria is not contagious and for most patients the condition may be managed well with treatment and avoidance of mast cell stimulants:

1. Certain foods: eggs, nuts, fruits,shellfish, fish, chocolates

2. Certain drugs: antibiotics, NSAIDs

3. Physical stimulants: pressure, sweating, cold temperature, sunlight

4. Infections: viral, bacteria

5. Others: flowers, pollen, beestings, animal furs, soaps

What are the symptoms and signs of Urticaria?
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The rash is typically itchy and appear rapidly as localised red swelling on the skin measuring a few mm to more than 10 cm in size in different shapes.

The swelling can also occur on eyelids, lips, palms and soles.

Urticaria is usually harmless and disappear within a few days or week.

However because it can involve very extensive areas of the body, it can cause a lot of irritation and a lot of anxiety.

Very rarely the urticaria can lasts months to years causing disruption to work and social life.

What makes patients with Urticaria itch?
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In people with Urticaria, the mast cell stimulant can cause histamine release from mast cells.

The histamine is the predominant chemical which is responsible for the inflammatory response which leads to changes of the blood vessels of the skin.

This leads to more blood flow to the affected skin and excessive fluid moving into the surrounding tissues , causing itching and swelling.

How can Urticaria be treated?
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One of the most important part of treatment is to to try to identify the substance or underlying medical condtion which may cause the Urticaria.
Avoidance of the causative substance or treatment of the underlying medical conditions such as infections will lead to the resolution of the urticaria.

One of the most important components of an Urticaria treatment routine is to prevent scratching.

Cold compresses applied directly to itchy skin can also help relieve itching.

Antihistamine tablets will usually relieve the itch and suppress the eruption of the rash.
The antihistamine need to be taken regularly for long as the urticaria is active.

If the condition persists, worsens, or does not improve satisfactorily, another effective treatment is the application of nonprescription corticosteroid creams and ointments to reduce itch.

Corticosteroid tablets may be prescribed if necessary.

How can Urticaria be prevented?
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Find the causative agent and avoid it.

Avoid sudden changes in temperature or humidity

Avoid sweating or overheating

Avoid certain foods (e.g.,eggs, nuts, seafood, chocolates)

Avoid harsh soaps, detergents, and solvents

Avoid environmental factors that trigger allergies (e.g., pollens, molds, mites, and animal dander)