A Simple Guide to Guillain-Barre Syndrome
---------------------------------------------------
What is Guillain-Barre Syndrome?
----------------------------------------
Guillain-Barre Syndrome is a rare autoimmune progressive disease with relatively symmetrical weakness of 2 or more limbs due to neuropathy, areflexia and mild sensory symptoms of not more than 4 weeks duration.
The Guillain-Barre Syndrome is a condition also called acute inflammatory demyelinating polyneuropathy (AIDP).
What causes Guillain-Barre Syndrome?
-------------------------------------------
In Guillain-Barre Syndrome, antibodies produced by the body's immune system attacks the gangliosides of cranial, spinal and peripheral nerve usually after:
1.a nonspecific respiratory or gastrointestinal viral illness
2.infectious mononucleosis
3.Campylobacter jejuni , cytomegalovirus infection
4.vaccination
5.extreme exposure to cold
The result of the antibodies attack on the peripheral nerves is inflammation of myelin and blockage of nerve conduction, resulting in muscle paralysis with sensory or autonomic deficits.
Who is at risk of Guillain-Barre Syndrome?
----------------------------------------------------
Guillain-Barre Syndrome occurs at any age usually at age 30-40.
It occurs more in men than in women.
What are the symptoms of Guillain-Barre Syndrome?
-------------------------------------------------------
The typical feature of Guillain-Barre Syndrome is
1.acute onset of symmetrical muscle weakness in both lower limbs with
ascending progression of the weakness upwards to the arms and face usually within hours or days.
2.the lower cranial nerves can also be affected leading to bulbar weakness, (dysphagia or difficulty with swallowing) and respiratory difficulties. If this happens , hospitalisation is a must.
3.Sensory loss is usually minor with loss of position, numbness or tingling sensation.
4.areflexia or complete loss of deep tendon reflexes is always present.
5.Loss of pain and temperature sensation may be present but mild.
6.pain is a common symptom with deep aching pain usually in the weakened muscles.
7.Autonomic dysfunction such as tachycardia, diarrhea, bladder dysfunction may occur but are usually transient.
8.absence of fever is one of the sign of Guillian Barre Syndrome.
If there is fever, another cause should be suspected.
Recovery usually begins 2-4 weeks after progression of disease stops.
How is the diagnosis of Guillain-Barre Syndrome made?
----------------------------------------------------------------
The diagnosis of Guillain-Barre Syndrome involve
1.History of a rapid onset and progression of ascending motor weakness, areflexia and the absence of fever.
2.physical and neurological examinations for peripheral neurological deficit.
3.cerebrospinal fluid examination-
typical CSF findings show albumino-cytological dissociation,
a. an elevated protein level (100 - 1000 mg/dL)
b. absent pleocytosis (increased cell count)unlike infectious causes.
4.Electromyographic studies and nerve conduction studies may show prolonged distal latencies, conduction slowing, nerve conduction blockage suggestive of demyelination.
5.Computed tomography or MRI may show actual demyelination of the nerve.
What are the complications for Guillain-Barre Syndrome ?
--------------------------------------------------------
1.Progression of nerve involvement to whole body
2.Paralysis of respiratory muscles and swallowing can be life threatening
What is the treatment for Guillain-Barre Syndrome ?
---------------------------------------------------------
Treatment for Guillain-Barre Syndrome may be urgent especially in cases of respiratory distress:
1.Hospitalisation and early intubation with a respirator on standby in case of difficulty in respiration
2.treatment of the underlying cause is started as soon as possible:
a. High dose intravenous immune globulin, which temporarily modifies the immune system and provides the body with normal antibodies from donated blood or
b.plasmapheresis in which abnormal antibodies are removed from the blood.
3.rehabilitation is atrted after the patient is stable and will focus on improving activities of daily living functions such as brushing teeth, washing and getting dressed.
4.physiotherapy to strengthen muscles
5.Speech therapy for speech and awallowing
6. Corticosteroids have no part to play in the treatment of Guillian Barre Syndrome.
What is the prognosis of Guillian-Barre Syndrome?
------------------------------------------------------------
1.With all these new treatments the prognosis for most patients with Guillain-Barre Syndrome is good with 80% recovery within 1 year
2.Some of them may have persistant minor neurological deficits such as areflexia.
3.Some 5% recover but with severe disability involving severe proximal motor and sensory axonal damage with inability of axonal regeneration.
4.About 10% of patients have relapses and are as classified as having chronic inflammatory demyelinating polyneuropathy
5.Death is rare(5%) and may be due to severe paralysis, autonomic dysfunction and other severe pulmonary complications.
Tuesday, September 30, 2008
Monday, September 29, 2008
A Simple Guide to Gastroesophageal reflux disease
A Simple Guide to Gastroesophageal reflux disease II
----------------------------------------------------------------
What are the Complications of untreated Gastroesophageal reflux disease?
-------------------------------------------------------------------------
GERD complications include
1.stricture formation,
2.Barrett's esophagus,
3.esophageal spasms,
4.esophageal ulcers,
5.esophageal cancer, especially in adults over 60 years old.
What is the treatment of Gastroesophageal reflux disease?
-------------------------------------------------------------------
Treatment is aimed at
A. prevention of reflux:
---------------------------
1.weight loss for the Obese
2.Positional therapy
a.Sleeping on the left side has been shown to drastically reduce nighttime reflux episodes in patients
b.Elevating the head of the bed is also effective.
The head of the bed can be raised by wooden bed risers that support bed posts or legs.
Elevation must be at least 6 to 8 inches (15 to 20 cm) to be able to prevent the backflow of gastric fluids.
c.a bed wedge pillow will also help to raise the patient's body higher
3.Certain foods should be avoided to prevent gastroesophageal reflux:
a.Coffee,
b.alcohol,
c.Acidic foods, such as oranges,tomatoes and excess amounts of Vitamin C
d.Antacids based on calcium carbonate actually increase the acidity of the stomach.
e.Foods high in fats -delay stomach emptying
f.Carbonated soft drinks with or without sugar.
g.Chocolate and peppermint.
h.Cruciferous vegetables: onions, cabbage, cauliflower, broccoli, spinach, brussels sprouts.
i.Milk and milk-based products containing calcium and fat,
j.Eating within 2 hours before bedtime.
k.Large meals- smaller meals reduces GERD risk, as it means there is less food in the stomach at any one time.
4.Smoking reduce lower esophageal sphincter competence, and should be avoided
5. Posture and GERD
Slouching causes a kink between the stomach and esophagus.
The esophageal muscles become twisted in a spasm.
Gas and acid get trapped in the spasm,causing irritation to the throat and the windpipe resulting in cough and asthmatic symptoms.
6.Avoid stress.
Learn to relax or meditate.
Adopt a healthy lifestyle with exercises to improve flow of food down the stomach.
B. Neutralizing the Gastric Acid Reflux
-----------------------------------------------
1. Drug treatment
a.Proton pump inhibitors are the best drugs used in reducing gastric acid secretion. (eg Nexium, Losec)
b.Antacids taken before meals half hourly after symptoms begin can reduce gastric acidity (liquid antacid are more useful than tablets)
c.Alginic acid (Gaviscon) protects the mucosa as well as increase pH and decrease reflux.
d.Gastric H2 receptor blockers such as ranitidine or famotidine decrease gastric secretion of acid.
e.Sucralfate (Carafate) is used to help heal and prevent esophageal damage caused by GERD, however it must be taken several times daily and at least two hours apart from meals and medications.
2. Surgical treatment
The standard surgical treatment, done laparoscopically, is the Nissen fundoplication.
The upper part of the stomach is wrapped around the Lower Esophageal Sphincter(LES) to strengthen the sphincter and prevent acid reflux and to repair a hiatal hernia.
3.New treatments
Eight years ago some new endoscopic devices to treat chronic heartburn were approved:
a.The Endocinch apply stitches in the LES to help strengthen the muscle.
b.The Stretta Procedure uses electrodes to use radio frequency energy to strengthen the LES.
c.The Plicator creates a plication, or fold, of tissue near the gastroesophageal junction, and fix the fold using a suture-based implant.
What is the prognosis of Gastroesophageal reflux disease?
------------------------------------------------------------
It is a chronic disease so treatment is lifelong and recurrences are common.
How is Gastroesophageal reflux disease prevented?
-------------------------------------------------------
1.Prevent heartburn by limiting acidic foods, such as grapefruit, oranges, tomatoes, or vinegar
2.Spicy foods - Cut down on pepper or chilies.
3.Avoid lying down for two to three hours after meals.
When you are sitting up, gravity helps drain food and stomach acid into your stomach.
4.Eat lean meats and non-fatty foods.
Greasy foods (like French fries and cheeseburgers) can trigger heartburn.
5.Avoid GERD symptom triggers- chocolate, mint, citrus, tomatoes, pepper, vinegar, catsup, and mustard.
6.Avoid drinks that can trigger reflux, such as alcohol, drinks with caffeine, and carbonated drinks.
7.Eat smaller meals to avoid triggering GERD symptoms.
8.Avoid stress.
Learn to relax or meditate.
Adopt a healthy lifestyle with exercises to improve flow of food down the stomach.
----------------------------------------------------------------
What are the Complications of untreated Gastroesophageal reflux disease?
-------------------------------------------------------------------------
GERD complications include
1.stricture formation,
2.Barrett's esophagus,
3.esophageal spasms,
4.esophageal ulcers,
5.esophageal cancer, especially in adults over 60 years old.
What is the treatment of Gastroesophageal reflux disease?
-------------------------------------------------------------------
Treatment is aimed at
A. prevention of reflux:
---------------------------
1.weight loss for the Obese
2.Positional therapy
a.Sleeping on the left side has been shown to drastically reduce nighttime reflux episodes in patients
b.Elevating the head of the bed is also effective.
The head of the bed can be raised by wooden bed risers that support bed posts or legs.
Elevation must be at least 6 to 8 inches (15 to 20 cm) to be able to prevent the backflow of gastric fluids.
c.a bed wedge pillow will also help to raise the patient's body higher
3.Certain foods should be avoided to prevent gastroesophageal reflux:
a.Coffee,
b.alcohol,
c.Acidic foods, such as oranges,tomatoes and excess amounts of Vitamin C
d.Antacids based on calcium carbonate actually increase the acidity of the stomach.
e.Foods high in fats -delay stomach emptying
f.Carbonated soft drinks with or without sugar.
g.Chocolate and peppermint.
h.Cruciferous vegetables: onions, cabbage, cauliflower, broccoli, spinach, brussels sprouts.
i.Milk and milk-based products containing calcium and fat,
j.Eating within 2 hours before bedtime.
k.Large meals- smaller meals reduces GERD risk, as it means there is less food in the stomach at any one time.
4.Smoking reduce lower esophageal sphincter competence, and should be avoided
5. Posture and GERD
Slouching causes a kink between the stomach and esophagus.
The esophageal muscles become twisted in a spasm.
Gas and acid get trapped in the spasm,causing irritation to the throat and the windpipe resulting in cough and asthmatic symptoms.
6.Avoid stress.
Learn to relax or meditate.
Adopt a healthy lifestyle with exercises to improve flow of food down the stomach.
B. Neutralizing the Gastric Acid Reflux
-----------------------------------------------
1. Drug treatment
a.Proton pump inhibitors are the best drugs used in reducing gastric acid secretion. (eg Nexium, Losec)
b.Antacids taken before meals half hourly after symptoms begin can reduce gastric acidity (liquid antacid are more useful than tablets)
c.Alginic acid (Gaviscon) protects the mucosa as well as increase pH and decrease reflux.
d.Gastric H2 receptor blockers such as ranitidine or famotidine decrease gastric secretion of acid.
e.Sucralfate (Carafate) is used to help heal and prevent esophageal damage caused by GERD, however it must be taken several times daily and at least two hours apart from meals and medications.
2. Surgical treatment
The standard surgical treatment, done laparoscopically, is the Nissen fundoplication.
The upper part of the stomach is wrapped around the Lower Esophageal Sphincter(LES) to strengthen the sphincter and prevent acid reflux and to repair a hiatal hernia.
3.New treatments
Eight years ago some new endoscopic devices to treat chronic heartburn were approved:
a.The Endocinch apply stitches in the LES to help strengthen the muscle.
b.The Stretta Procedure uses electrodes to use radio frequency energy to strengthen the LES.
c.The Plicator creates a plication, or fold, of tissue near the gastroesophageal junction, and fix the fold using a suture-based implant.
What is the prognosis of Gastroesophageal reflux disease?
------------------------------------------------------------
It is a chronic disease so treatment is lifelong and recurrences are common.
How is Gastroesophageal reflux disease prevented?
-------------------------------------------------------
1.Prevent heartburn by limiting acidic foods, such as grapefruit, oranges, tomatoes, or vinegar
2.Spicy foods - Cut down on pepper or chilies.
3.Avoid lying down for two to three hours after meals.
When you are sitting up, gravity helps drain food and stomach acid into your stomach.
4.Eat lean meats and non-fatty foods.
Greasy foods (like French fries and cheeseburgers) can trigger heartburn.
5.Avoid GERD symptom triggers- chocolate, mint, citrus, tomatoes, pepper, vinegar, catsup, and mustard.
6.Avoid drinks that can trigger reflux, such as alcohol, drinks with caffeine, and carbonated drinks.
7.Eat smaller meals to avoid triggering GERD symptoms.
8.Avoid stress.
Learn to relax or meditate.
Adopt a healthy lifestyle with exercises to improve flow of food down the stomach.
Sunday, September 28, 2008
A Simple Guide to Gastroesophageal reflux disease
A Simple Guide to Gastroesophageal reflux disease I
------------------------------------------------------------
What is Gastroesophageal reflux disease?
--------------------------------------------------------
Gastroesophageal reflux disease (GERD) is a chronic disease of the esophagus whose mucosa is damaged by abnormal reflux of gastric acid from the stomach to the esophagus.
What are the risk factors in Gastroesophageal reflux disease?
---------------------------------------------------------------------------
1.Incompetant Lower Esophageal Sphincter(LES) allow the acid and gastric juice to reflux up the esophagus
2.Hiatus hernia - hole in diaphragm separating esophagus from stomach is enlarged allowing the easier flow of acid up the esophagus
3.Obesity and pregnancy: increased body weight cause pressure in the abdomen to push gastric contents upwards towards esophagus
4.Zollinger-Ellison syndrome- this condition typically increase gastric acid
5.Hypercalcemia, increase gastrin production, leading to increased acidity
6.Corticosteroids like prednisolone - can irritate the stomach mucosa and increase gastric acid
7.Scleroderma and Multiple sclerosis with esophageal involvement
Factors which has been associated with GERD :
8.Obstructive sleep apnea
9.Gallstones which can impede the flow of bile and digestion of fats
What are the causes of Gastroesophageal reflux disease?
------------------------------------------------------------------
1.incompetence of the cardia(junction between the stomach and esophagus),
2.transient cardia relaxation,
3.impaired expulsion of gastric reflux from the esophagus
4.hiatus hernia.
What are the Symptoms of Gastroesophageal reflux disease?
----------------------------------------------------------------------
The most common symptoms are
1.Heartburn - there is a burning discomfort behind the breastbone due to acid flow up the esophagus
2.difficulty swallowing (dysphagia)- due to narrowing of the esophagus (persistent implies stricture while intermittent implies spasm)
3.chronic chest pain - pain is behind the central sternum as a result of acid in the esophagus
4.cough - the acid flow up the esophagus can irritate the larynx and spark off the cough reflex
5.hoarseness- due to inflammation of the vocal cords from the acid reflux
6.voice changes- as above
7.chronic ear ache- inflammation of the throat from acid relux an also affect the eustachian tube of the middle ear resulting in pain
8.burning chest pains- again due to the gastric acid in esophagus
9.nausea and belching- too much acid to the throat can cause the nausea and expulsion of air effect
10.sinusitis - acid can also find its way up the throat and into the sinuses.
11.esophagitis (reflux esophagitis)- acid low up the esophagus causing pain
worse on lying down
12.strictures are narrowing of the esophagus resulting from acid in the esophagus
If the reflux affects the throat and larynx, it is called laryngopharyngeal reflux disease.
How do you diagnose Gastroesophageal reflux disease?
---------------------------------------------------------------
A detailed history of acid reflux into the esophagus.
Useful investigations may include
1.barium swallow X-rays,
2.esophageal manometry - measures the pressure in the esophagus
3.24-hour esophageal pH monitoring - measures the acidity of the esophagus
4.Esophagogastroduodenoscopy (EGD) involves insertion of a thin scope through the mouth and throat into the esophagus and stomach in order to assess the internal surfaces of the esophagus, stomach, and duodenum.
In general, an EGD is done when:
1.the patient does not respond well to treatment,
2.has danger symptoms including:
dysphagia,
anemia,
blood in the stool (detected chemically),
wheezing,
weight loss,
voice changes.
Esophagogastroduodenoscopy can show peptic stricture, or narrowing of the esophagus near the junction with the stomach.
This can cause dysphagia or difficulty in swallowing
Biopsies done during gastroscopy may show:
1.Edema and basal hyperplasia (non-specific)
2.Lymphocytic inflammation (non-specific)
3.Neutrophilic inflammation (usually due to reflux or Helicobacter Gastroesophageal reflux disease)
4.Eosinophilic inflammation (usually due to reflux)
5.Goblet cell intestinal metaplasia or Barretts esophagus.
6.Elongation of the papillae
7.Thinning of the squamous cell layer
8.Dysplasia or pre-cancer.
9.Carcinoma.
10.Reflux changes may be non-erosive in nature, leading to the non-erosive reflux disease.
Saturday, September 27, 2008
A Simple Guide to Acne Rosacea
A Simple Guide to Acne Rosacea
-----------------------------------------------
What is Acne Rosacea?
----------------------------------
Acne Rosacea is a chronic inflammatory disease of the skin which typically redness of the cheeks with maculopapular rashes.
Who Gets Acne Rosacea?
-----------------------
Acne Rosacea occurs more in females than in males.
It is also more common in the middle ages.
It is rare in children
What causes Acne Rosacea?
-------------------------------------
The cause of Acne Rosacea is unknown.
Some possible causes are:
1.menopause with flushing of the face due to hormonal
2.Excessive sebum production in the sebaceous glands
3.stress aggravate the condition
4.Alcohol and certain foods(seafood with its high histamine content, spicy food) can cause flushing
What are the symptoms of Acne Rosacea?
-------------------------------------------------
Onset is sudden or gradual.
They may last weeks or months and be recurrent.
Frequently they become chronic.
The typical rash of Acne Rosacea is well-defined :
1.red (rosy cheek)
2.small blood vessel seen in rashes
3.hypertrophic sebaceous glands without blockage of ducts
4.papular rash.
5.Typically on forehead, cheeks, nose, chin or center of face
6.Associated seborrheic dermatitis of the scalp(dandruff)and eyelids (blepharitis)
7.Eye lesions may include:
tearing of eyes
photophobia
visual disturbances
corneal infections
conjunctivitis
How does Acne Rosacea affects the Patient?
-----------------------------------------
All types of Acne Rosacea can affect a person’s quality of life.
1.Appearance of face
2.Blood vessel on nose
3.papular rashes on the face
What is the Treatment of Acne Rosacea?
-----------------------------------
Treatment depends on the severity and type of Acne Rosacea.
1.mild cases may not require any treatment
2.Avoid food that can cause flushing such as alcohol, spicy foods, hot drinks
3.Avoid stress and tension
Treatments:
1.Topical Medicines include:
sulphur containing creams and shampoo to dry the oil from the skin
2.Systemic antibiotics like tetracycline or erythromycin
3.Phototherapy (with ultraviolet B, psoralen with ultraviolet A radiation)
4.Avoid corticosteroids which usually make the condition worse
5.Surgical treatment of rhinophyma and laser treatment of dilated blood vessels
At the present moment there is no known cure for Acne Rosacea.
Medicines have been able to reduce the severity of inflammation and improve the quality of life.
What is the Prognosis of Acne Rosacea?
-----------------------------------------------
There is generally no cure for Acne Rosacea.
Treatment is good with prolonged antibiotic therapy.
Lifelong treatment may be necessary to control signs and symptoms.
-----------------------------------------------
What is Acne Rosacea?
----------------------------------
Acne Rosacea is a chronic inflammatory disease of the skin which typically redness of the cheeks with maculopapular rashes.
Who Gets Acne Rosacea?
-----------------------
Acne Rosacea occurs more in females than in males.
It is also more common in the middle ages.
It is rare in children
What causes Acne Rosacea?
-------------------------------------
The cause of Acne Rosacea is unknown.
Some possible causes are:
1.menopause with flushing of the face due to hormonal
2.Excessive sebum production in the sebaceous glands
3.stress aggravate the condition
4.Alcohol and certain foods(seafood with its high histamine content, spicy food) can cause flushing
What are the symptoms of Acne Rosacea?
-------------------------------------------------
Onset is sudden or gradual.
They may last weeks or months and be recurrent.
Frequently they become chronic.
The typical rash of Acne Rosacea is well-defined :
1.red (rosy cheek)
2.small blood vessel seen in rashes
3.hypertrophic sebaceous glands without blockage of ducts
4.papular rash.
5.Typically on forehead, cheeks, nose, chin or center of face
6.Associated seborrheic dermatitis of the scalp(dandruff)and eyelids (blepharitis)
7.Eye lesions may include:
tearing of eyes
photophobia
visual disturbances
corneal infections
conjunctivitis
How does Acne Rosacea affects the Patient?
-----------------------------------------
All types of Acne Rosacea can affect a person’s quality of life.
1.Appearance of face
2.Blood vessel on nose
3.papular rashes on the face
What is the Treatment of Acne Rosacea?
-----------------------------------
Treatment depends on the severity and type of Acne Rosacea.
1.mild cases may not require any treatment
2.Avoid food that can cause flushing such as alcohol, spicy foods, hot drinks
3.Avoid stress and tension
Treatments:
1.Topical Medicines include:
sulphur containing creams and shampoo to dry the oil from the skin
2.Systemic antibiotics like tetracycline or erythromycin
3.Phototherapy (with ultraviolet B, psoralen with ultraviolet A radiation)
4.Avoid corticosteroids which usually make the condition worse
5.Surgical treatment of rhinophyma and laser treatment of dilated blood vessels
At the present moment there is no known cure for Acne Rosacea.
Medicines have been able to reduce the severity of inflammation and improve the quality of life.
What is the Prognosis of Acne Rosacea?
-----------------------------------------------
There is generally no cure for Acne Rosacea.
Treatment is good with prolonged antibiotic therapy.
Lifelong treatment may be necessary to control signs and symptoms.
A Simple Guide to Intertrigo
A Simple Guide to Intertrigo
-----------------------------------
What is Intertrigo?
---------------------------
Intertrigo is a moist red seborrheic (oil gland) skin rash affecting body clefts such as armpits and groins.
What are the causes of Intertrigo?
----------------------------------------
The seborrheic glands (oil glands) in the skin secretes excessive sebum(oil) especially in areas which tends to rubs against each other such as armpits, groins, skin under the breasts, and navel.
Because of the irritation of the skin and secretion of sebum, a red moist form of rash appears.
What are Signs and symptoms of Intertrigo?
---------------------------------------------
Symptoms:
1.moist rash
2.red skin
3.may be oily
Signs:
1.Typical red moist macular rash
2.may have sebum present
3.appears mainly at axilla, groin, submammary skin
How is the diagnosis of Intertrigo made?
------------------------------------------
1.Symptoms and signs of moist red seborrheic type of rash
2.Skin scraping to exclude fungal infection.
What are the complications of Intertrigo?
-----------------------------------------------
1.Fungal infection
2.bacterial infection
What is the treatment of Intertrigo?
------------------------------------
1.Control of dandruff and other seborrheic conditions
2.Anifungal and antibiotic cream applied to skin lesions.
3.Corticosteroid cream may help reduce inflammation
What is the prognosis of Intertrigo ?
------------------------------------------
Generally excellent but may recur.
What are the Preventive measures taken for Intertrigo ?
--------------------------------------------------------
1.Lose weight in obese patient(less friction)
2.Good skin hygiene
3.Healthy lifestyle with balanced diet and adequate sleep.
4.Proper skin care of the axilla, groins, submammary ares, navel
-----------------------------------
What is Intertrigo?
---------------------------
Intertrigo is a moist red seborrheic (oil gland) skin rash affecting body clefts such as armpits and groins.
What are the causes of Intertrigo?
----------------------------------------
The seborrheic glands (oil glands) in the skin secretes excessive sebum(oil) especially in areas which tends to rubs against each other such as armpits, groins, skin under the breasts, and navel.
Because of the irritation of the skin and secretion of sebum, a red moist form of rash appears.
What are Signs and symptoms of Intertrigo?
---------------------------------------------
Symptoms:
1.moist rash
2.red skin
3.may be oily
Signs:
1.Typical red moist macular rash
2.may have sebum present
3.appears mainly at axilla, groin, submammary skin
How is the diagnosis of Intertrigo made?
------------------------------------------
1.Symptoms and signs of moist red seborrheic type of rash
2.Skin scraping to exclude fungal infection.
What are the complications of Intertrigo?
-----------------------------------------------
1.Fungal infection
2.bacterial infection
What is the treatment of Intertrigo?
------------------------------------
1.Control of dandruff and other seborrheic conditions
2.Anifungal and antibiotic cream applied to skin lesions.
3.Corticosteroid cream may help reduce inflammation
What is the prognosis of Intertrigo ?
------------------------------------------
Generally excellent but may recur.
What are the Preventive measures taken for Intertrigo ?
--------------------------------------------------------
1.Lose weight in obese patient(less friction)
2.Good skin hygiene
3.Healthy lifestyle with balanced diet and adequate sleep.
4.Proper skin care of the axilla, groins, submammary ares, navel
Thursday, September 25, 2008
A Simple Guide to Impetigo
A Simple Guide to Impetigo
-----------------------------------
What is Impetigo?
---------------------------
Impetigo is a vesiculopustular skin infection occurring mainly at all ages.
What are the causes of Impetigo?
----------------------------------------
Bacterial Infections:
----------------------------
1.Gram positive bacteria such as Streptococcus and Staphphylococcus are common
2.Gram negative bacteria such as Klebsiella, E.coli, Pseudomonas,
What are Signs and symptoms of Impetigo?
---------------------------------------------
Symptoms:
1.vesicles that appears rapidly on the face, hands and knee
2.Yellow liquid or pus discharges from vesicles
3.form crusts
Signs:
1.Vesicles rash present on face, hand and knees
2.yellow crusts appeared and spread to surrounding tissues
3.Neighboring lymph nodes may be enlarged
How is the diagnosis of Impetigo made?
------------------------------------------
1.Symptoms and signs of vesiculopustular lesions of the skin.
2.Culture and sensitivity to antibiotics of the discharge or crusts from skin lesions
What are the complications of Impetigo?
-----------------------------------------------
1.cellulitis
2.abscess
3.carbuncle( a group of abscesses which join together to become a large abscess
4.lymphadenitis
What is the treatment of Impetigo?
------------------------------------
1.Removal of crusts with warm saline or liquid paraffin
2.Strong antibiotic cream applied to skin lesions.
3. Strong systemic antibiotics
a.cephalosporin, penicillin, ampicillin, erythromycin, tetracycline, for most streptococci,
staphalococci,
hemophilus
b.cephalosporins, gentamycin for
pseudomonas
4.surgery to drain abscess and carbuncles may be necessary
What is the prognosis of Impetigo ?
------------------------------------------
Generally excellent with good healing
What are the Preventive measures taken for Impetigo ?
--------------------------------------------------------
1.Avoid touching skin with dirty hands
2.Good hand hygiene
3.Healthy lifestyle with balance diet and adequate sleep.
4.Proper skin care
Wednesday, September 24, 2008
A Simple Guide to Blepharitis
A Simple Guide to Blepharitis
-----------------------------------
What is Blepharitis?
---------------------------
Blepharitis is a disease which causes inflammation and infection of the margins of the eyelids.
What are the causes of Blepharitis?
----------------------------------------
Bacterial Infections:
----------------------------
1.Gram positive bacteria such as Streptococcus and Staphphylococcus are common
2.Gram negative bacteria such as Klebsiella, E.coli, Pseudomonas,
Parasitic Infections:
----------------------------
Deodex folliculorum rare cause
Non-infectious:
------------------
blocked oil glands of eyelashes
What are the types of Blepharitis?
----------------------------------------
Squamous:
--------------
typically scales on lashes- usually non-infectious
Ulcerative:
----------------
yellow crusts on eyelids which causes small bleeding ulcers when removed -
usually due to infections.
What are Signs and symptoms of Blepharitis?
---------------------------------------------
Symptoms:
1.Irritation and discomfort of eyelids
2.tearing of eyes
3.photophobia (fear of bright lights and sunlight)
4.Yellow discharge or crusts on eyelashes
Signs:
1.White scales on eyelashes in squamous blepharitis
2.yellow crusts on eyelashes in infectious blepharitis
3.small bleeding ulcers on eyelids where crusts have dropped.
4.Conjuctivitis
How is the diagnosis of Blepharitis made?
------------------------------------------
1.Symptoms and signs of scales, yellow crusts on eyelids
2.Culture and sensitivity to antibiotics of the discharge from eyedlids
3.Microscopic examination of eyelashes
What are the complications of Blepharitis?
-----------------------------------------------
1.Stye or chalazion of eyelid
2.Conjuctivitis
3.Scarring of eyelids
What is the treatment of Blepharitis?
------------------------------------
Squamous Blepharitis
-----------------------
1.Treatment of underlying cause such as seborrhoeic dermatitis
2.Application of antiseptic or antibiotic cream to eyelashes
Ulcerative Blepharitis
--------------------------
1.Rest in dark room
2.Painkiller for pain
3.Removal of crusts and diseased eyelashes by washing warm water or saline
4.Strong antibiotic eyedrops and cream applied to eyelashes:
a.cephalosporin, penicillin, ampicillin, tetracycline, for most streptococci, staphalococci, hemophilus
b.cephalosporins, gentamycin for pseudomonas
5.Treat associated conjunctivitis
What is the prognosis of Blepharitis ?
------------------------------------------
Squamous Blepharitis
-----------------------
Generally good.
May vary with response to underlying cause.
Recurrence is common.
Ulcerative Blepharitis
--------------------------
Most cases recovered well.
Rarely there may serious sequalae such as
loss of eyelashes,
scarring of eyelashes
conjuctival ulcers
What are the Preventive measures taken for Blepharitis ?
--------------------------------------------------------
1.Avoid rubbing of eyes with dirty hands
2.Good hand hygiene
3.Healthy lifestyle with balanced diet and adequate sleep.
4.Reducing watching of TV and computer monitors
5.Regular eye checkups
-----------------------------------
What is Blepharitis?
---------------------------
Blepharitis is a disease which causes inflammation and infection of the margins of the eyelids.
What are the causes of Blepharitis?
----------------------------------------
Bacterial Infections:
----------------------------
1.Gram positive bacteria such as Streptococcus and Staphphylococcus are common
2.Gram negative bacteria such as Klebsiella, E.coli, Pseudomonas,
Parasitic Infections:
----------------------------
Deodex folliculorum rare cause
Non-infectious:
------------------
blocked oil glands of eyelashes
What are the types of Blepharitis?
----------------------------------------
Squamous:
--------------
typically scales on lashes- usually non-infectious
Ulcerative:
----------------
yellow crusts on eyelids which causes small bleeding ulcers when removed -
usually due to infections.
What are Signs and symptoms of Blepharitis?
---------------------------------------------
Symptoms:
1.Irritation and discomfort of eyelids
2.tearing of eyes
3.photophobia (fear of bright lights and sunlight)
4.Yellow discharge or crusts on eyelashes
Signs:
1.White scales on eyelashes in squamous blepharitis
2.yellow crusts on eyelashes in infectious blepharitis
3.small bleeding ulcers on eyelids where crusts have dropped.
4.Conjuctivitis
How is the diagnosis of Blepharitis made?
------------------------------------------
1.Symptoms and signs of scales, yellow crusts on eyelids
2.Culture and sensitivity to antibiotics of the discharge from eyedlids
3.Microscopic examination of eyelashes
What are the complications of Blepharitis?
-----------------------------------------------
1.Stye or chalazion of eyelid
2.Conjuctivitis
3.Scarring of eyelids
What is the treatment of Blepharitis?
------------------------------------
Squamous Blepharitis
-----------------------
1.Treatment of underlying cause such as seborrhoeic dermatitis
2.Application of antiseptic or antibiotic cream to eyelashes
Ulcerative Blepharitis
--------------------------
1.Rest in dark room
2.Painkiller for pain
3.Removal of crusts and diseased eyelashes by washing warm water or saline
4.Strong antibiotic eyedrops and cream applied to eyelashes:
a.cephalosporin, penicillin, ampicillin, tetracycline, for most streptococci, staphalococci, hemophilus
b.cephalosporins, gentamycin for pseudomonas
5.Treat associated conjunctivitis
What is the prognosis of Blepharitis ?
------------------------------------------
Squamous Blepharitis
-----------------------
Generally good.
May vary with response to underlying cause.
Recurrence is common.
Ulcerative Blepharitis
--------------------------
Most cases recovered well.
Rarely there may serious sequalae such as
loss of eyelashes,
scarring of eyelashes
conjuctival ulcers
What are the Preventive measures taken for Blepharitis ?
--------------------------------------------------------
1.Avoid rubbing of eyes with dirty hands
2.Good hand hygiene
3.Healthy lifestyle with balanced diet and adequate sleep.
4.Reducing watching of TV and computer monitors
5.Regular eye checkups
Tuesday, September 23, 2008
A Simple Guide to Cytomegalovirus
A Simple Guide to Cytomegalovirus
-----------------------------------
What is Cytomegalovirus?
---------------------------
Cytomegalovirus is an acute viral disease of all ages which can be transmitted to the fetus before birth.
It affects people at all ages but seldom causes any symptoms in adults.
What are the causes of Cytomegalovirus?
----------------------------------------
Cytomegalovirus is a virus of the herpes group characterised by its ability to stay dormant in the body over a long period.
It is transmited in body fluid (urine, saliva ,blood, semen, tears and breast milk)
What are Signs and symptoms of Cytomegalovirus?
---------------------------------------------
Adult and children Cytomegalovirus infection do not normally give rise to symptoms except for mild fever and a mononucleosis-like illness.
Congenital Cytomegalovirus infections presents itself at birth:
1.Microcephaly
2.Hepatosplenomegaly with jaundice
3.Hearing impairment
4.Blindness
5.Chorioretinitis
6.Hemolytic anemia with petechiae
7.Seizures
8.Respiratory distress
How is the diagnosis of Cytomegalovirus made?
------------------------------------------
1.blood tests for igG or igM for Cytomegalovirus are positive within 3 weeks of birth
2.Usually appears normal at birth
3.Ultrasound during pregnancy to dentify any brain abnormalities .
4.Saliva , urine may be taken to test if there is presence of the Cytomegalovirus.
What are the complications of Cytomegalovirus?
-----------------------------------------------
1.Respiratory distress
2.Mental retardation
3.Hemolytic anemia
4.Blindness
5.Deafness
What is the treatment of Cytomegalovirus?
--------------------------------------------------
There is no effective treatment of Cytomegalovirus at the present moment.
A antiviral drug ganciclovir which is used to treat AIDS may help babies with Cytomegalovirus infection.
A vacine is also being developed for prevention.
What is the prognosis of Cytomegalovirus ?
------------------------------------------
Prognosis for congenital Cytomegalovirus infection is poor.
Adult Cytomegalovirus infection do not have any problem.
What are the Preventive measures taken for Cytomegalovirus ?
------------------------------------------------------------------
There is no vaccine at the present moment for Cytomegalovirus.
Transmission of Cytomegalovirus infection is always preventable because it is transmitted through body fluid from hand,nose and mouth of a suseceptible person.
People who interacts with children and pregnant mothers shuold practice good safe hygiene methods such as washing of hand and wearing of clothes when changing diapers.
Pregnant women are also advised to practice safe hygiene methods and to seek advice in the presence of a mononucleosis-like illness.
-----------------------------------
What is Cytomegalovirus?
---------------------------
Cytomegalovirus is an acute viral disease of all ages which can be transmitted to the fetus before birth.
It affects people at all ages but seldom causes any symptoms in adults.
What are the causes of Cytomegalovirus?
----------------------------------------
Cytomegalovirus is a virus of the herpes group characterised by its ability to stay dormant in the body over a long period.
It is transmited in body fluid (urine, saliva ,blood, semen, tears and breast milk)
What are Signs and symptoms of Cytomegalovirus?
---------------------------------------------
Adult and children Cytomegalovirus infection do not normally give rise to symptoms except for mild fever and a mononucleosis-like illness.
Congenital Cytomegalovirus infections presents itself at birth:
1.Microcephaly
2.Hepatosplenomegaly with jaundice
3.Hearing impairment
4.Blindness
5.Chorioretinitis
6.Hemolytic anemia with petechiae
7.Seizures
8.Respiratory distress
How is the diagnosis of Cytomegalovirus made?
------------------------------------------
1.blood tests for igG or igM for Cytomegalovirus are positive within 3 weeks of birth
2.Usually appears normal at birth
3.Ultrasound during pregnancy to dentify any brain abnormalities .
4.Saliva , urine may be taken to test if there is presence of the Cytomegalovirus.
What are the complications of Cytomegalovirus?
-----------------------------------------------
1.Respiratory distress
2.Mental retardation
3.Hemolytic anemia
4.Blindness
5.Deafness
What is the treatment of Cytomegalovirus?
--------------------------------------------------
There is no effective treatment of Cytomegalovirus at the present moment.
A antiviral drug ganciclovir which is used to treat AIDS may help babies with Cytomegalovirus infection.
A vacine is also being developed for prevention.
What is the prognosis of Cytomegalovirus ?
------------------------------------------
Prognosis for congenital Cytomegalovirus infection is poor.
Adult Cytomegalovirus infection do not have any problem.
What are the Preventive measures taken for Cytomegalovirus ?
------------------------------------------------------------------
There is no vaccine at the present moment for Cytomegalovirus.
Transmission of Cytomegalovirus infection is always preventable because it is transmitted through body fluid from hand,nose and mouth of a suseceptible person.
People who interacts with children and pregnant mothers shuold practice good safe hygiene methods such as washing of hand and wearing of clothes when changing diapers.
Pregnant women are also advised to practice safe hygiene methods and to seek advice in the presence of a mononucleosis-like illness.
Monday, September 22, 2008
A Simple Guide to Polycystic kidney disease
A Simple Guide to Polycystic kidney disease
---------------------------------------------------------
What are Polycystic kidney disease ?
-----------------------------------------------
Polycystic kidney disease is a progressive genetic condition of the kidneys in which multiple cysts (polycystic)are present in both kidneys.
The disease can produce cysts in the liver, pancreas, and rarely, the heart and brain.
Who is at risk of Polycystic kidney disease formation?
------------------------------------------------------------------
Any one with a family history of polycystic kidneys.
What causes Polycystic kidney disease ?
-------------------------------------------------------
There are 2 main causes of polycystic kidney disease.
Both are determined by their genetic inheritance:
1.Autosomal dominant
----------------------
It is generally a late-onset disease with progressive cyst development.
The kidneys are bilaterally enlarged and have multiple cysts.
There may be kidney dysfunction resulting in hypertension and kidney failure by the age of 60 years.
Beside this there are also cysts in other organs such as the liver, spleen, pancreas, and arachnoid mater.
Other abnormalities includes intracranial aneurysms, dissection of the aorta, mitral valve prolapse.
2.Autosomal recessive
-----------------------------
This disease is less common than the above.
Most cases died during the pregnancy or in the first month of birth.
Early manifestations of the disease is apparent at birth or in early infancy.
What are the symptoms of Polycystic kidney disease ?
------------------------------------------------------------
Many Polycystic kidney patients do not have any symptoms.
In some cases there may be:
1.hypertension,
2.Abdominal colic due to urinary stones
3.back or flank pain
4.urinary tract infections with hematuria and proteinuria
5.Palpable large kidneys
6.Abdominal swelling
7.fatigue
The condition eventually ends in chronic renal failure with loss of kidney function.
How are Polycystic kidney disease diagnosed?
---------------------------------------------------------------
1.X-rays of the kidneys on routine checkup
2.Ultrasound of the kidneys
3.MRI of the kidneys
4.genetic testing
Genetic counseling may help families at risk for polycystic kidney disease.
How are Polycystic kidney disease treated?
--------------------------------------------------------
There is no cure for Polycystic kidney disease.
Although a cure for Polycystic kidney disease is not possible, treatment can ease the symptoms and prolong life.
1.Back Pain:
Mild pain killers such as paracetamol can relieve pain.
2.Urinary tract infections:
urinary tract infections can be treated with antibiotics.
Any urinary infection can spread from the urinary tract to the kidney cysts so early treatment is important.
Once the infection enter the cyst, treatment is difficult because many antibiotics cannot enter the walls of the cysts.
3.High blood pressure:
All hypertension cases due to Polycystic kidney disease must be kept under control with medications and lifestyle changes such as exercise, distressing, low salt and fats
4.Renal disease:
Eventually in all cases the kidney function will fail and chronic real failure develop.
Treatment will then be by dialysis or kidney transplant.
5.Surgery:
Surgery is rarely needed except to remove large cysts. Even then the kidney disease is progressive and will still end in chronic renal failure.
What is the prognosis of Polycystic kidney disease?
----------------------------------------------------------
Generally poor after the age of 60 when renal disease may set in.
How to prevent Polycystic kidney disease ?
-----------------------------------------------------------------
There is no prevention for Polycystic kidney disease.
---------------------------------------------------------
What are Polycystic kidney disease ?
-----------------------------------------------
Polycystic kidney disease is a progressive genetic condition of the kidneys in which multiple cysts (polycystic)are present in both kidneys.
The disease can produce cysts in the liver, pancreas, and rarely, the heart and brain.
Who is at risk of Polycystic kidney disease formation?
------------------------------------------------------------------
Any one with a family history of polycystic kidneys.
What causes Polycystic kidney disease ?
-------------------------------------------------------
There are 2 main causes of polycystic kidney disease.
Both are determined by their genetic inheritance:
1.Autosomal dominant
----------------------
It is generally a late-onset disease with progressive cyst development.
The kidneys are bilaterally enlarged and have multiple cysts.
There may be kidney dysfunction resulting in hypertension and kidney failure by the age of 60 years.
Beside this there are also cysts in other organs such as the liver, spleen, pancreas, and arachnoid mater.
Other abnormalities includes intracranial aneurysms, dissection of the aorta, mitral valve prolapse.
2.Autosomal recessive
-----------------------------
This disease is less common than the above.
Most cases died during the pregnancy or in the first month of birth.
Early manifestations of the disease is apparent at birth or in early infancy.
What are the symptoms of Polycystic kidney disease ?
------------------------------------------------------------
Many Polycystic kidney patients do not have any symptoms.
In some cases there may be:
1.hypertension,
2.Abdominal colic due to urinary stones
3.back or flank pain
4.urinary tract infections with hematuria and proteinuria
5.Palpable large kidneys
6.Abdominal swelling
7.fatigue
The condition eventually ends in chronic renal failure with loss of kidney function.
How are Polycystic kidney disease diagnosed?
---------------------------------------------------------------
1.X-rays of the kidneys on routine checkup
2.Ultrasound of the kidneys
3.MRI of the kidneys
4.genetic testing
Genetic counseling may help families at risk for polycystic kidney disease.
How are Polycystic kidney disease treated?
--------------------------------------------------------
There is no cure for Polycystic kidney disease.
Although a cure for Polycystic kidney disease is not possible, treatment can ease the symptoms and prolong life.
1.Back Pain:
Mild pain killers such as paracetamol can relieve pain.
2.Urinary tract infections:
urinary tract infections can be treated with antibiotics.
Any urinary infection can spread from the urinary tract to the kidney cysts so early treatment is important.
Once the infection enter the cyst, treatment is difficult because many antibiotics cannot enter the walls of the cysts.
3.High blood pressure:
All hypertension cases due to Polycystic kidney disease must be kept under control with medications and lifestyle changes such as exercise, distressing, low salt and fats
4.Renal disease:
Eventually in all cases the kidney function will fail and chronic real failure develop.
Treatment will then be by dialysis or kidney transplant.
5.Surgery:
Surgery is rarely needed except to remove large cysts. Even then the kidney disease is progressive and will still end in chronic renal failure.
What is the prognosis of Polycystic kidney disease?
----------------------------------------------------------
Generally poor after the age of 60 when renal disease may set in.
How to prevent Polycystic kidney disease ?
-----------------------------------------------------------------
There is no prevention for Polycystic kidney disease.
Sunday, September 21, 2008
A Simple Guide to Tenosynovitis
A Simple Guide to Tenosynovitis
----------------------------------------------------
What is Tenosynovitis?
-----------------------------------------
Tenosynovitis is the inflammation and swelling of the tendon sheaths (called the synovium) and the enclosed tendons.
It can occur together with tendinitis(inflammation of the tendons).
It can also cause stenosing tenosynovitis (tightening inflammation of the tendon sheaths).
What are the cause of Tenosynovitis?
-----------------------------------------------
The cause of Tenosynovitis is unknown.
Some possible causes are:
1.Injury or trauma to the tendon
2.Repetitive usage of fingers and wrist joints
3.Arthritis of the joints may predispose to tenosynovitis
4.Systemic diseases such as multiple sclerosis ,amyloidosis, rheumatoid arthritis
5.Tenosynovitis occurs in families, and
6.It is generally seen more often in males than in females
What are the symptoms and signs of Tenosynovitis?
-------------------------------------------------------------------
Symptoms:
--------------
1.Pain on movement of the tendon
2.Swelling of part of the tendon affected
3.Stenosis of the tendon sheath may be present
4.Stiffness of the tendon - inability to stretch
5.Pain is felt most beneath the bone of involved joints
Signs:
1.swelling over the involved tendon
2.Passive stretching of the tendon is painful.
3.There may be local tenderness of the inflamed tendon.
4.The tendons sheaths are usually swollen and thickened
5.The tendons may become stuck in the narrowed tendon sheaths (Trigger Finger)
6.There may be crepitations felt over the tendon as it moves across the sheaths
What is the complications of Tenosynovitis?
-------------------------------------------------
Fibrosis and rupture of the inflamed tendon may occur leading to loss of function.
What is the Treatment of Tenosynovitis?
----------------------------------------------------------------
Conservative treatment:
-----------------------
1.rest of the tendon
2.Cold or ice may help reduce inflammation
3.Splints over the hand, wrist and elbow may help to rest the tendons
4.Pain killers such as NSAID(non-steroidal anti-inflammatory drugs) for pain
5.Muscle relaxant to relax muscles
6.injection of local anesthetic and long acting steroid into the affected sheath or tendon nodule may help to reduce inflammation
7.Surgery :
------------------
Surgical opening of the synovial sheath may be necessary for tendon release.
What is the prognosis of Tenosynovitis?
----------------------------------------------------------
Prognosis is usually good although recurrence may occur after cortisone injection.
Surgery usually give excellent results.
----------------------------------------------------
What is Tenosynovitis?
-----------------------------------------
Tenosynovitis is the inflammation and swelling of the tendon sheaths (called the synovium) and the enclosed tendons.
It can occur together with tendinitis(inflammation of the tendons).
It can also cause stenosing tenosynovitis (tightening inflammation of the tendon sheaths).
What are the cause of Tenosynovitis?
-----------------------------------------------
The cause of Tenosynovitis is unknown.
Some possible causes are:
1.Injury or trauma to the tendon
2.Repetitive usage of fingers and wrist joints
3.Arthritis of the joints may predispose to tenosynovitis
4.Systemic diseases such as multiple sclerosis ,amyloidosis, rheumatoid arthritis
5.Tenosynovitis occurs in families, and
6.It is generally seen more often in males than in females
What are the symptoms and signs of Tenosynovitis?
-------------------------------------------------------------------
Symptoms:
--------------
1.Pain on movement of the tendon
2.Swelling of part of the tendon affected
3.Stenosis of the tendon sheath may be present
4.Stiffness of the tendon - inability to stretch
5.Pain is felt most beneath the bone of involved joints
Signs:
1.swelling over the involved tendon
2.Passive stretching of the tendon is painful.
3.There may be local tenderness of the inflamed tendon.
4.The tendons sheaths are usually swollen and thickened
5.The tendons may become stuck in the narrowed tendon sheaths (Trigger Finger)
6.There may be crepitations felt over the tendon as it moves across the sheaths
What is the complications of Tenosynovitis?
-------------------------------------------------
Fibrosis and rupture of the inflamed tendon may occur leading to loss of function.
What is the Treatment of Tenosynovitis?
----------------------------------------------------------------
Conservative treatment:
-----------------------
1.rest of the tendon
2.Cold or ice may help reduce inflammation
3.Splints over the hand, wrist and elbow may help to rest the tendons
4.Pain killers such as NSAID(non-steroidal anti-inflammatory drugs) for pain
5.Muscle relaxant to relax muscles
6.injection of local anesthetic and long acting steroid into the affected sheath or tendon nodule may help to reduce inflammation
7.Surgery :
------------------
Surgical opening of the synovial sheath may be necessary for tendon release.
What is the prognosis of Tenosynovitis?
----------------------------------------------------------
Prognosis is usually good although recurrence may occur after cortisone injection.
Surgery usually give excellent results.
Saturday, September 20, 2008
A Simple Guide to Ovarian torsion
A Simple Guide to Ovarian torsion
----------------------------------------------------
What is a Ovarian torsion?
---------------------------------------
Ovarian torsion is the twisting of the Ovary either spontaneously or due to another medical condition.
Ovarian torsion occurs usually in only one Ovary at a time.
Both normal or enlarged ovaries can be affected.
Rarely both ovaries may be affected.
It is a medical emergency as gangrene of Ovary may occur.
Who is at risk of Ovarian torsion?
----------------------------------------
Women of all ages can develop this rare condition.
Most cases occur in women under 30 years old.
One fifth of all cases occur in pregnant women.
What is the Cause of Ovarian torsion?
-----------------------------------------------------
Ovarian torsion is caused by
1.congenital and developmental abnormalities
Longer than normal tubes or a missing mesosalpinx will cause ovarian torsion.
2.disease that affects the tube or Ovary resulting in the twisting of the ovarian axis.
a.Spasms or changes in the blood vessels in the mesosalpinx can cause the blood vessels to the ovaries to be congested resulting in torsion of the ovaries.
b.Ovarian cysts or fibromas,
c.tumor of the Ovaries or tubes,
d.Injury to either the ovaries or the tubes
What are the Symptoms and signs of Ovarian torsion?
-----------------------------------------------------------
Symptoms :
--------------
1.sudden onset of extreme lower abdominal pain that radiates to the back, side and thigh.
2.Nausea, vomiting,
3.diarrhea, or constipation
4.fever
5.tachycardia.
Signs:
-------------
1.tenderness of the lower abdomen
2.tenderness of the Ovarian region on vaginal palpation
How do you make the Diagnosis of Ovarian torsion?
------------------------------------------------------------
1.suddenness of lower abdominal pain.
2.pregnancy test.
3. ultrasound and CT scan (computed tomography) can help to visualise the ovarian structures
4.laparoscopy.
What are the complications of Ovarian torsion?
---------------------------------------------------
Damage to the Ovary with gangrene formation due to loss of blood flow.
What is the treatment of Ovarian torsion?
---------------------------------------------------
Surgical repair of the ovarian torsion must done urgently.
For less severe cases laparoscopic surgery can release the torsion
Pain killers such as NSAIDs are given to control pain.
What is the prognosis of Ovarian torsion?
-----------------------------------------
The prognosis is usually good if the ovarian trosion is detected early and treated.
If however the treatment is delayed there is a danger of arterial blood flow into and venous blood flow out of the Ovarian may be compromised resulting in necrosis (death) of the ovarian tissue.
Infertility may be a result of ovarian torsion.
----------------------------------------------------
What is a Ovarian torsion?
---------------------------------------
Ovarian torsion is the twisting of the Ovary either spontaneously or due to another medical condition.
Ovarian torsion occurs usually in only one Ovary at a time.
Both normal or enlarged ovaries can be affected.
Rarely both ovaries may be affected.
It is a medical emergency as gangrene of Ovary may occur.
Who is at risk of Ovarian torsion?
----------------------------------------
Women of all ages can develop this rare condition.
Most cases occur in women under 30 years old.
One fifth of all cases occur in pregnant women.
What is the Cause of Ovarian torsion?
-----------------------------------------------------
Ovarian torsion is caused by
1.congenital and developmental abnormalities
Longer than normal tubes or a missing mesosalpinx will cause ovarian torsion.
2.disease that affects the tube or Ovary resulting in the twisting of the ovarian axis.
a.Spasms or changes in the blood vessels in the mesosalpinx can cause the blood vessels to the ovaries to be congested resulting in torsion of the ovaries.
b.Ovarian cysts or fibromas,
c.tumor of the Ovaries or tubes,
d.Injury to either the ovaries or the tubes
What are the Symptoms and signs of Ovarian torsion?
-----------------------------------------------------------
Symptoms :
--------------
1.sudden onset of extreme lower abdominal pain that radiates to the back, side and thigh.
2.Nausea, vomiting,
3.diarrhea, or constipation
4.fever
5.tachycardia.
Signs:
-------------
1.tenderness of the lower abdomen
2.tenderness of the Ovarian region on vaginal palpation
How do you make the Diagnosis of Ovarian torsion?
------------------------------------------------------------
1.suddenness of lower abdominal pain.
2.pregnancy test.
3. ultrasound and CT scan (computed tomography) can help to visualise the ovarian structures
4.laparoscopy.
What are the complications of Ovarian torsion?
---------------------------------------------------
Damage to the Ovary with gangrene formation due to loss of blood flow.
What is the treatment of Ovarian torsion?
---------------------------------------------------
Surgical repair of the ovarian torsion must done urgently.
For less severe cases laparoscopic surgery can release the torsion
Pain killers such as NSAIDs are given to control pain.
What is the prognosis of Ovarian torsion?
-----------------------------------------
The prognosis is usually good if the ovarian trosion is detected early and treated.
If however the treatment is delayed there is a danger of arterial blood flow into and venous blood flow out of the Ovarian may be compromised resulting in necrosis (death) of the ovarian tissue.
Infertility may be a result of ovarian torsion.
Friday, September 19, 2008
A Simple Guide to Croup
A Simple Guide to Croup
-----------------------------------
What is Croup?
---------------------------
Croup is an acute viral disease of the upper and lower respiratory tract associated with inspiratory stridor ( whistling obstructive sound during inhalation) and respiratory distress in severe cases.
It typically affects infants and children below 6 years old.
It causes a typically barking type of cough and hoarseness of the voice due to obstruction at the vocal box.
What are the causes of Croup?
----------------------------------------
Viral infections:
--------------------
1.parainfluenza virus, primarily types 1 and 2
2.Other viral infections such as adenorhinovirnese, enterovirus and mycoplasma pneumoniae
Genetic predisposition:
------------------------
Some families are more prone than others to get the disease.
It is also more common in males than females.
What are Signs and symptoms of Croup?
---------------------------------------------
Symptoms:
1.harsh barking cough
2.sneeze
3.inspiratory stridor (a high-pitched whistling sound during inspiration),
4.nausea and vomiting
5.fever.
6.Hoarseness -usually present
7.respiratory distress due to airway obstruction
8.lethargy
Signs:
1.Reduced breath sounds - air movement is reduced in the lungs
2.Prolonged inspiration on auscultation with laryngeal stridor
3.Chest retraction
4.Cyanosis(blue color) of the lips and fingers if not enough oxygen is entering.
This will considered as a medical emergency.
How is the diagnosis of Croup made?
------------------------------------------
1.Symptoms and signs of fever, laryngeal stridor and barking cough
2.blood tests (complete blood count, ESR and blood culture)
5.frontal X-ray of the C-spine
the presence of the the steeple sign confirms the diagnosis of croup.
What are the complications of Croup?
-----------------------------------------------
1.Respiratory distress
2.Bacterial tracheitis
What is the treatment of Croup?
------------------------------------
1.Rest, fluids and oxygen
2.Humidifiers and steam inhalations
3.Corticosteroids especially dexamethasone are the most commonly used agent as it reduces inflammation
4.Antibiotics are not useful because the cause is viral. If there is bacterial tracheitis, antibiotics may be needed
5.Bronchodilators such as theophylline, epinephrine, ventolin, bricanyl are all helpful to open the airways
6.Intubation and tracheostomy may be needed in severe cases.
What is the prognosis of Croup ?
------------------------------------------
This depends on the severity and type of infection.
Most cases, if treated early and correctly, recovered completely with return of normal lung function within 7 days.
What are the Preventive measures taken for Croup ?
--------------------------------------------------------
Vaccination against the influenza virus may help.
Thursday, September 18, 2008
A Simple Guide to Obstructive Sleep Apnea
A Simple Guide to Obstructive Sleep Apnea
----------------------------------------------------
What is Obstructive Sleep Apnea?
--------------------------------------
Obstructive Sleep Apnea (OSA) is the absence of respiratory airflow (for 10 seconds or more) during sleep despite respiratory effort due to upper airway obstruction.
Patients with OSA do not have adequate sleep and may have problem staying awake during the day posing problems in their employment during the day and keeping their family awake at night.
What are the causes of Obstructive Sleep Apnea?
-----------------------------------------------------
Obstruction causes:
----------------------------
1.Inadequate muscle tone of the palate, tongue and pharynx leads to airway collapse during inspiration during the deep stage sleep.
2.bulky tissue in the upper respiratory airway(adenoids and tonsillar hypertrophy, cysts and tumors)
3.excessive soft palatial tissue or long uvula
4.receding chin resulting in a backward prolapsing tongue
5.anatomical abnormalities in the nose(deviated nasal septum, hypertrophied inferior turbinates) or congested nasal passages (allergies, sinusitis, nasal polyps)
Systemic disorders:
-------------------------
1.Hypothyroidism
2.Acromegaly
3.Alcohol
4.Sedatives
5.Obesity
What are Signs and symptoms of Obstructive Sleep Apnea?
-------------------------------------------------------------
Symptoms:
1.snoring present in 20% of men and 5% of women at age 30-35 years.
At age 60years or more, 60% of men and 40% of women snore habitually
2.unrefreshed sleep
3.daytime sleepiness
4.poor concentration
5.forgetfulness
6.morning headaches
7.dryness of mouth in the morning
8.irritability
9.depression
10.sexual dysfunction
Signs:
1.Enlarged nasal turbinates, polyps , and nasal blockage
2.Enlarged tonsils and adenoids
3.Long uvula
4.large protruding tongue
How is the diagnosis of Obstructive Sleep Apnea made?
--------------------------------------------------------------
A.Symptoms of snoring, nasal congestion and inadequate sleep
B.observation of airway obstruction during sleep
C.Sleep study using monitoring devices such as
1.electroencephalogram(EEG)- brain waves
2 electro-oculogram(EOG) - ocular or eye muscle movement
3.Electro-myogram (EMG) - chin and leg movement
4.Electrocardiogram(ECG) - electrical activity of the heart
5.Blood oxygen studies
6.Body position
7.Nasal and oral airflow
8.Thoracic movement
9.abdominal movement
10.Snoring sounds
What are the complications of Obstructive Sleep Apnea?
-----------------------------------------------
1.higher risk of hypertension
2.cardiovascular disease
3.Congestive heart failure
4.cardiac arrhythmias
5.cerebrovascular accidents
What is the treatment of Obstructive Sleep Apnea?
------------------------------------
Non Surgical treatment:
--------------------------
1.Continuous Positive Airway Pressure(CPAP)
CPAP administered by mask through the nose is the single most effective and least invasive treatment for OSA.
It can improve all the bad effects of OSA.
2.Oral appliances which pushes the mandible forward and prevent it from falling open during sleep
3.Nasal Congestion treatment:
Patients with nasal congestion and blockage should be treated with antihistamine and decongestant
4. Weight reduction:
Any obese patients should have at least 10% of his weight reduced over a 6 months period
Surgical Treatments:
--------------------------
1.Surgery on the upper pharyngeal airway (uvula and palate)
a.Radiofrequency reduction is indicated in simple snorer or mild OSA.
b.Uvulopalatopharyngeal (UPPP) surgery includes uvulectomy, palatal releasing and shortening incisions.
2.Surgery of the Tongue base:
Radiofrequency reduction is done for mild cases.
Advancement of the tongue, hyoid suspension is done under general anesthesia. All these enlarge the posterior airway space.
3.Maxillomandibular Advancement:
This is the most effective surgical procedure for treatment of OSA.
It causes enlargement of the pharyngeal and hypopharyngeal airway by physically expanding the skeletal framework.
What is the prognosis of Obstructive Sleep Apnea ?
--------------------------------------------------------
This depends on the severity of the condition but is generally good.
What are the Preventive measures taken for Obstructive Sleep Apnea ?
---------------------------------------------------------------------
1.Lose weight in obese individual with OSA
2.Healthy lifestyle with balanced diet and exercise.
3.Neck elevation
4.Avoid alcohol
----------------------------------------------------
What is Obstructive Sleep Apnea?
--------------------------------------
Obstructive Sleep Apnea (OSA) is the absence of respiratory airflow (for 10 seconds or more) during sleep despite respiratory effort due to upper airway obstruction.
Patients with OSA do not have adequate sleep and may have problem staying awake during the day posing problems in their employment during the day and keeping their family awake at night.
What are the causes of Obstructive Sleep Apnea?
-----------------------------------------------------
Obstruction causes:
----------------------------
1.Inadequate muscle tone of the palate, tongue and pharynx leads to airway collapse during inspiration during the deep stage sleep.
2.bulky tissue in the upper respiratory airway(adenoids and tonsillar hypertrophy, cysts and tumors)
3.excessive soft palatial tissue or long uvula
4.receding chin resulting in a backward prolapsing tongue
5.anatomical abnormalities in the nose(deviated nasal septum, hypertrophied inferior turbinates) or congested nasal passages (allergies, sinusitis, nasal polyps)
Systemic disorders:
-------------------------
1.Hypothyroidism
2.Acromegaly
3.Alcohol
4.Sedatives
5.Obesity
What are Signs and symptoms of Obstructive Sleep Apnea?
-------------------------------------------------------------
Symptoms:
1.snoring present in 20% of men and 5% of women at age 30-35 years.
At age 60years or more, 60% of men and 40% of women snore habitually
2.unrefreshed sleep
3.daytime sleepiness
4.poor concentration
5.forgetfulness
6.morning headaches
7.dryness of mouth in the morning
8.irritability
9.depression
10.sexual dysfunction
Signs:
1.Enlarged nasal turbinates, polyps , and nasal blockage
2.Enlarged tonsils and adenoids
3.Long uvula
4.large protruding tongue
How is the diagnosis of Obstructive Sleep Apnea made?
--------------------------------------------------------------
A.Symptoms of snoring, nasal congestion and inadequate sleep
B.observation of airway obstruction during sleep
C.Sleep study using monitoring devices such as
1.electroencephalogram(EEG)- brain waves
2 electro-oculogram(EOG) - ocular or eye muscle movement
3.Electro-myogram (EMG) - chin and leg movement
4.Electrocardiogram(ECG) - electrical activity of the heart
5.Blood oxygen studies
6.Body position
7.Nasal and oral airflow
8.Thoracic movement
9.abdominal movement
10.Snoring sounds
What are the complications of Obstructive Sleep Apnea?
-----------------------------------------------
1.higher risk of hypertension
2.cardiovascular disease
3.Congestive heart failure
4.cardiac arrhythmias
5.cerebrovascular accidents
What is the treatment of Obstructive Sleep Apnea?
------------------------------------
Non Surgical treatment:
--------------------------
1.Continuous Positive Airway Pressure(CPAP)
CPAP administered by mask through the nose is the single most effective and least invasive treatment for OSA.
It can improve all the bad effects of OSA.
2.Oral appliances which pushes the mandible forward and prevent it from falling open during sleep
3.Nasal Congestion treatment:
Patients with nasal congestion and blockage should be treated with antihistamine and decongestant
4. Weight reduction:
Any obese patients should have at least 10% of his weight reduced over a 6 months period
Surgical Treatments:
--------------------------
1.Surgery on the upper pharyngeal airway (uvula and palate)
a.Radiofrequency reduction is indicated in simple snorer or mild OSA.
b.Uvulopalatopharyngeal (UPPP) surgery includes uvulectomy, palatal releasing and shortening incisions.
2.Surgery of the Tongue base:
Radiofrequency reduction is done for mild cases.
Advancement of the tongue, hyoid suspension is done under general anesthesia. All these enlarge the posterior airway space.
3.Maxillomandibular Advancement:
This is the most effective surgical procedure for treatment of OSA.
It causes enlargement of the pharyngeal and hypopharyngeal airway by physically expanding the skeletal framework.
What is the prognosis of Obstructive Sleep Apnea ?
--------------------------------------------------------
This depends on the severity of the condition but is generally good.
What are the Preventive measures taken for Obstructive Sleep Apnea ?
---------------------------------------------------------------------
1.Lose weight in obese individual with OSA
2.Healthy lifestyle with balanced diet and exercise.
3.Neck elevation
4.Avoid alcohol
Wednesday, September 17, 2008
A Simple Guide to Cervicitis
A Simple Guide to Cervicitis
----------------------------------------------------
What is Cervicitis?
---------------------------------------
Cervicitis is non-specific infection of the cervix.
It is most common on the posterior cervix but may be anterior or concentric.
Who is affected by Cervicitis?
---------------------------------------------------
1.Congeital cervical erosions or cervicitis can occur in virgins.
2.sexually active females
3.dilatation in labor or during abortion
What are the types of Cervicitis?
-------------------------------------------
1.Simple:
Erosion surface is smooth
2.Papillary:
Erosion surface is rough
3.Follicular:
Erosion surface is cystic
What are the Causes of Cervicitis?
-----------------------------------------------------
Bacterial infections:
---------------------------
1.Gonorrhea
2.Chlamydia
3.staphylococcus aureus
4.Streptococcus
5.Mycobacterium tuberculosis.
6.E.coli
Viral infections:
--------------------------
1.Genital herpes
2.Human Papilloma Virus
Other causes:
--------------------
1.Cervical cap
2.Device to support the uterus (pessary)
3.Diaphragm
4.allergy to spermicides
5.Exposure to a chemical
What are the complications of Cervicitis?
---------------------------------------------------
1.Pelvic inflammatory disease
2.Urethritis and cystitis
3.rarely malignant changes in cervix
4.inguinal lymphadenitis
5.Cervical cancer
What are the Symptoms and signs of Cervicitis?
-----------------------------------------------------------
1.Mucopurulent vaginal discharge (Gray, white, or yellow color) with odor
2.Blood in the vaginal discharge
a.After intercourse
b.After menopause
c.Between periods
3.Urinary infection symptoms - frequency and pain
3.hematuria (blood in the urine)
4.Pelvic pain
5.Backache
6.Painful sexual intercourse
7.Pain in the vagina
8.Pressure or heaviness in the pelvis
Signs:
1.reddened area of cervix
2.erosion of cervical wall
3.Vaginal surface of cervix may be affected
4.pus discharge from the cervix
5.Swelling (inflammation) of the walls of the vagina
How is diagnosis of Cervicitis made?
-----------------------------------------------
1.Vaginal examination with Pap's smear of cervical cells
2.Cervical swab for culture and sensitivity to antibiotics
3.Blood tests( white cell count , blood culture, chlamydia, gonorrhea)
4.Biopsy of cervical erosions.
What is the treatment of Cervicitis?
---------------------------------------------------
1. Antibiotics is given according to the sensitivity of bacteria in the culture.
2.Pelvic pain and backache may be treated with paracetamol
3.Local application of sulphonamide, tetracycline or other antibiotic cream to affected cervical area
4.Electro-Cauterisation of the affected cervical area
5.Cryosurgery of cervical erosions
6.Cone biopsy if necessary of affected cervix area.
7.Hormonal therapy (especially in postmenopausal women)
8.Laser therapy of cervical erosions
What is the prognosis of Cervicitis?
-------------------------------------------------------------
Prognosis with appropriate treatment and antibiotics is generally good.
Recurrence is common.
Cervicitis may last for months to years.
Cervicitis may lead to pain with intercourse (dyspareunia).
What are Preventive measures for Cervicitis?
-------------------------------------------------------------------
Avoid sexual intercourse with multiple partners.
Use condoms during sexual intercourse.
Vaccination against human papilloma virus
Avoid chemical irritants such as douches and deodorant tampons.
Avoid using spermicidal contraceptives
Make sure that any foreign objects that inserted into the vagina is clean or sterile
----------------------------------------------------
What is Cervicitis?
---------------------------------------
Cervicitis is non-specific infection of the cervix.
It is most common on the posterior cervix but may be anterior or concentric.
Who is affected by Cervicitis?
---------------------------------------------------
1.Congeital cervical erosions or cervicitis can occur in virgins.
2.sexually active females
3.dilatation in labor or during abortion
What are the types of Cervicitis?
-------------------------------------------
1.Simple:
Erosion surface is smooth
2.Papillary:
Erosion surface is rough
3.Follicular:
Erosion surface is cystic
What are the Causes of Cervicitis?
-----------------------------------------------------
Bacterial infections:
---------------------------
1.Gonorrhea
2.Chlamydia
3.staphylococcus aureus
4.Streptococcus
5.Mycobacterium tuberculosis.
6.E.coli
Viral infections:
--------------------------
1.Genital herpes
2.Human Papilloma Virus
Other causes:
--------------------
1.Cervical cap
2.Device to support the uterus (pessary)
3.Diaphragm
4.allergy to spermicides
5.Exposure to a chemical
What are the complications of Cervicitis?
---------------------------------------------------
1.Pelvic inflammatory disease
2.Urethritis and cystitis
3.rarely malignant changes in cervix
4.inguinal lymphadenitis
5.Cervical cancer
What are the Symptoms and signs of Cervicitis?
-----------------------------------------------------------
1.Mucopurulent vaginal discharge (Gray, white, or yellow color) with odor
2.Blood in the vaginal discharge
a.After intercourse
b.After menopause
c.Between periods
3.Urinary infection symptoms - frequency and pain
3.hematuria (blood in the urine)
4.Pelvic pain
5.Backache
6.Painful sexual intercourse
7.Pain in the vagina
8.Pressure or heaviness in the pelvis
Signs:
1.reddened area of cervix
2.erosion of cervical wall
3.Vaginal surface of cervix may be affected
4.pus discharge from the cervix
5.Swelling (inflammation) of the walls of the vagina
How is diagnosis of Cervicitis made?
-----------------------------------------------
1.Vaginal examination with Pap's smear of cervical cells
2.Cervical swab for culture and sensitivity to antibiotics
3.Blood tests( white cell count , blood culture, chlamydia, gonorrhea)
4.Biopsy of cervical erosions.
What is the treatment of Cervicitis?
---------------------------------------------------
1. Antibiotics is given according to the sensitivity of bacteria in the culture.
2.Pelvic pain and backache may be treated with paracetamol
3.Local application of sulphonamide, tetracycline or other antibiotic cream to affected cervical area
4.Electro-Cauterisation of the affected cervical area
5.Cryosurgery of cervical erosions
6.Cone biopsy if necessary of affected cervix area.
7.Hormonal therapy (especially in postmenopausal women)
8.Laser therapy of cervical erosions
What is the prognosis of Cervicitis?
-------------------------------------------------------------
Prognosis with appropriate treatment and antibiotics is generally good.
Recurrence is common.
Cervicitis may last for months to years.
Cervicitis may lead to pain with intercourse (dyspareunia).
What are Preventive measures for Cervicitis?
-------------------------------------------------------------------
Avoid sexual intercourse with multiple partners.
Use condoms during sexual intercourse.
Vaccination against human papilloma virus
Avoid chemical irritants such as douches and deodorant tampons.
Avoid using spermicidal contraceptives
Make sure that any foreign objects that inserted into the vagina is clean or sterile
Tuesday, September 16, 2008
A Simple Guide to Epididymitis and Orchitis
A Simple Guide to Epididymitis and Orchitis
----------------------------------------------------
What is Epididymitis and Orchitis?
---------------------------------------
Epididymitis and orchitis is acute bacterial or viral infection of the epididymis and testis.
The epididymis is the small organ on top of the testis.
Who is affected by Epididymitis and Orchitis?
---------------------------------------------------
1.childhood, usually related to mumps infection
2.sexually active males
3.Epididymitis is more common than Orchitis
What are the Causes of Epididymitis and Orchitis?
-----------------------------------------------------
Bacterial infections:
1.Gonorrhea
2.Chlamydia
3.staphylococcus aureus
4.Streptococcus
5.Mycobacterium tuberculosis.
6.E.coli
Viral infections:
1.mumps in childhood
2.measles
What are the complications of Epididymitis and Orchitis?
---------------------------------------------------
1.Orchitis or infection of the testis following epididymitis
2.Abscess formation of the epididymis
3.gangrene of the testis if blood flow is affected.
4.inguinal lymphadenitis
What are the Symptoms and signs of Epididymitis and Orchitis?
-----------------------------------------------------------
1.Pain in scrotum
2.ejaculation of blood
3.hematuria (blood in the urine)
4.Fever
Signs:
1.Scrotal swelling
2.Induration of scrotum wall
3.tenderness of epididymis
4.tenderness of the testis if orchitis is present
How is diagnosis of Epididymitis and Orchitis made?
-----------------------------------------------
1.pain and tenderness of the epididymis and testis
2.Mid stream urine for culture
3.Blood tests( white cell count , blood culture)
4.Ultrasound of the testis
What is the treatment of Epididymitis and Orchitis?
---------------------------------------------------
Acute Epididymitis and Orchitis
1. Antibiotics may be commenced if fever is high or the culture showed bacterial infections.
2.Fever and pain may be treated with paracetamol
3.Scrotal support
4.Ice packs for scrotum
5.Bed rest and Fluids
6.Surgical drainage if there is abscess formation.
What is the prognosis of Epididymitis and Orchitis?
-------------------------------------------------------------
Prognosis with appropriate treatment and antibiotics is generally good.
There is a risk of sterility and decreased male hormone production if treatment is inadequate.
What are Preventive measures for Epididymitis and Orchitis?
-------------------------------------------------------------------
Avoid sexual partners with multiple partners.
Use condoms during sexual intercourse.
----------------------------------------------------
What is Epididymitis and Orchitis?
---------------------------------------
Epididymitis and orchitis is acute bacterial or viral infection of the epididymis and testis.
The epididymis is the small organ on top of the testis.
Who is affected by Epididymitis and Orchitis?
---------------------------------------------------
1.childhood, usually related to mumps infection
2.sexually active males
3.Epididymitis is more common than Orchitis
What are the Causes of Epididymitis and Orchitis?
-----------------------------------------------------
Bacterial infections:
1.Gonorrhea
2.Chlamydia
3.staphylococcus aureus
4.Streptococcus
5.Mycobacterium tuberculosis.
6.E.coli
Viral infections:
1.mumps in childhood
2.measles
What are the complications of Epididymitis and Orchitis?
---------------------------------------------------
1.Orchitis or infection of the testis following epididymitis
2.Abscess formation of the epididymis
3.gangrene of the testis if blood flow is affected.
4.inguinal lymphadenitis
What are the Symptoms and signs of Epididymitis and Orchitis?
-----------------------------------------------------------
1.Pain in scrotum
2.ejaculation of blood
3.hematuria (blood in the urine)
4.Fever
Signs:
1.Scrotal swelling
2.Induration of scrotum wall
3.tenderness of epididymis
4.tenderness of the testis if orchitis is present
How is diagnosis of Epididymitis and Orchitis made?
-----------------------------------------------
1.pain and tenderness of the epididymis and testis
2.Mid stream urine for culture
3.Blood tests( white cell count , blood culture)
4.Ultrasound of the testis
What is the treatment of Epididymitis and Orchitis?
---------------------------------------------------
Acute Epididymitis and Orchitis
1. Antibiotics may be commenced if fever is high or the culture showed bacterial infections.
2.Fever and pain may be treated with paracetamol
3.Scrotal support
4.Ice packs for scrotum
5.Bed rest and Fluids
6.Surgical drainage if there is abscess formation.
What is the prognosis of Epididymitis and Orchitis?
-------------------------------------------------------------
Prognosis with appropriate treatment and antibiotics is generally good.
There is a risk of sterility and decreased male hormone production if treatment is inadequate.
What are Preventive measures for Epididymitis and Orchitis?
-------------------------------------------------------------------
Avoid sexual partners with multiple partners.
Use condoms during sexual intercourse.
Monday, September 15, 2008
A Simple Guide to Testicular torsion
A Simple Guide to Testicular torsion
----------------------------------------------------
What is a Testicular torsion?
---------------------------------------
Testicular torsion is the twisting of the testis on its cord either spontaneously or following strenuous activity.
It is a medical emergency as gangrene of testis may occur.
What is the Cause of Testicular torsion?
-----------------------------------------------------
Testicular torsion is caused by
1.incomplete fixation of the epididymis to the testis
2.inadequate attachment of the mesorchium.(testicular body)
3.loose ligaments holding the testis to its cord .
Because of the loose attachment sudden movement of the testis on its cord may cause the testis to be twisted resulting in sudden reduction of blood flow to the testis leading to gangrene of the testis.
What are the Symptoms and signs of Testicular torsion?
-----------------------------------------------------------
Symptoms :
1.Severe pain in the testis
2.nausea and vomiting
3.fever
Signs:
1.scrotal swelling and edema
2.tenderness of the testis on palpation
3.redness and inflammation of the scrotal pouch
4.enlarged scrotal pouch
How do you make the Diagnosis of Testicular torsion?
------------------------------------------------------------
1.Characteristic appearance of the testis
2.Ultrasound examination can detect the obvious torsion
What are the complications of Testicular torsion?
---------------------------------------------------
Damage to the testis with gangrene formation
What is the treatment of Testicular torsion?
---------------------------------------------------
The only treatment is surgical treatment to untangle the torsion and fasten the testis tightly to its attachment.
Removal of the testis (orchidectomy) may be necessary if there is gangrene.
What is the prognosis of Testicular torsion?
----------------------------------------------
The prognosis is usually excellent if treated early.
Gangrenous testis must be removed.
How can Testicular Torsion be prevented?
---------------------------------------------
Avoid strenuous activities
Wear loose underwear
----------------------------------------------------
What is a Testicular torsion?
---------------------------------------
Testicular torsion is the twisting of the testis on its cord either spontaneously or following strenuous activity.
It is a medical emergency as gangrene of testis may occur.
What is the Cause of Testicular torsion?
-----------------------------------------------------
Testicular torsion is caused by
1.incomplete fixation of the epididymis to the testis
2.inadequate attachment of the mesorchium.(testicular body)
3.loose ligaments holding the testis to its cord .
Because of the loose attachment sudden movement of the testis on its cord may cause the testis to be twisted resulting in sudden reduction of blood flow to the testis leading to gangrene of the testis.
What are the Symptoms and signs of Testicular torsion?
-----------------------------------------------------------
Symptoms :
1.Severe pain in the testis
2.nausea and vomiting
3.fever
Signs:
1.scrotal swelling and edema
2.tenderness of the testis on palpation
3.redness and inflammation of the scrotal pouch
4.enlarged scrotal pouch
How do you make the Diagnosis of Testicular torsion?
------------------------------------------------------------
1.Characteristic appearance of the testis
2.Ultrasound examination can detect the obvious torsion
What are the complications of Testicular torsion?
---------------------------------------------------
Damage to the testis with gangrene formation
What is the treatment of Testicular torsion?
---------------------------------------------------
The only treatment is surgical treatment to untangle the torsion and fasten the testis tightly to its attachment.
Removal of the testis (orchidectomy) may be necessary if there is gangrene.
What is the prognosis of Testicular torsion?
----------------------------------------------
The prognosis is usually excellent if treated early.
Gangrenous testis must be removed.
How can Testicular Torsion be prevented?
---------------------------------------------
Avoid strenuous activities
Wear loose underwear
Sunday, September 14, 2008
A Simple Guide to Retinitis pigmentosa
A Simple Guide to Retinitis pigmentosa
----------------------------------------------
What is Retinitis pigmentosa?
---------------------------------------
Retinitis pigmentosa is a slow degenerative disease of the retina.
Who is affected by Retinitis pigmentosa?
------------------------------------------------
Retinitis pigmentosa is a genetically determined disease in which abnormal photoreceptors (rods and cones) or the Retinitis pigment epithelium of the retina cause progressive loss of vision.
Initially there is night blindness due to the abnormal photoreceptors.
This is followed by the loss of peripheral visual field known as tunnel
vision which may persist for some years.
Finally the macular region is affected with loss of central vision in the later stages.
In rare cases blindness may occur in childhood.
What is the cause of Retinitis pigmentosa?
------------------------------------------------
The cause is usually in the genes and of the recessive trait.
There is a mild form of dominant trait.
Rarely it is sex linked and can be severe.
What are symptoms and signs of Retinitis pigmentosa?
---------------------------------------------------------
Symptoms:
--------------
1.loss of night vision even in childhood
2.tunnel vision occurs at age of 40-50 for several years or decades
3.loss of central vision usually at 50-60 years of age
Signs:
-----------------
1. In early stage, direct opthalmoscopy show small spidery black spots
2. vessels are sheathed with pigments in some areas
3. Retinal vessels become attenuated (thinned)
4. Optic atrophy(cellophane maculopathy) sets in
5. posterior subcapsular cataracts form at late stage.
How is Retinitis pigmentosa diagnosed?
---------------------------------------------
1. electroretinography (ERG) show progressive loss of photoreceptor function
2.Visual field testing show loss of peripheral vision
3.Flourescin angiography may show dark pigments to establish the presence of Retinitis pigmentosa.
What are the complications of Retinitis pigmentosa?
-------------------------------------------------------
Partial to complete loss of vision.
What is the treatment for Retinitis pigmentosa?
-------------------------------------------------
Retinitis pigmentosa has no cure.
Several methods of treatment aimed at slowing down the progression of loss of vision have been tried:
1.daily intake of 15000 IU of vitamin A palmitate.
2.Retinitis transplants,
3 artificial Retinitis implants,
4.gene therapy,
5.stem cells,
How is Retinitis pigmentosa monitored?
-----------------------------------------
1.regular follow up with the eye doctor.
2.examining the retina for further damage
3.analyzing the visual fields.
What is the prognosis of Retinitis pigmentosa?
----------------------------------------------------
The prognosis is very poor as progression to blindness is the rule.
How can Retinitis pigmentosa be prevented?
-----------------------------------------------
There is no prevention for Retinitis pigmentosa.
The following may help:
1.Genetic counselling
2.Examination of family members for signs of loss of vision
----------------------------------------------
What is Retinitis pigmentosa?
---------------------------------------
Retinitis pigmentosa is a slow degenerative disease of the retina.
Who is affected by Retinitis pigmentosa?
------------------------------------------------
Retinitis pigmentosa is a genetically determined disease in which abnormal photoreceptors (rods and cones) or the Retinitis pigment epithelium of the retina cause progressive loss of vision.
Initially there is night blindness due to the abnormal photoreceptors.
This is followed by the loss of peripheral visual field known as tunnel
vision which may persist for some years.
Finally the macular region is affected with loss of central vision in the later stages.
In rare cases blindness may occur in childhood.
What is the cause of Retinitis pigmentosa?
------------------------------------------------
The cause is usually in the genes and of the recessive trait.
There is a mild form of dominant trait.
Rarely it is sex linked and can be severe.
What are symptoms and signs of Retinitis pigmentosa?
---------------------------------------------------------
Symptoms:
--------------
1.loss of night vision even in childhood
2.tunnel vision occurs at age of 40-50 for several years or decades
3.loss of central vision usually at 50-60 years of age
Signs:
-----------------
1. In early stage, direct opthalmoscopy show small spidery black spots
2. vessels are sheathed with pigments in some areas
3. Retinal vessels become attenuated (thinned)
4. Optic atrophy(cellophane maculopathy) sets in
5. posterior subcapsular cataracts form at late stage.
How is Retinitis pigmentosa diagnosed?
---------------------------------------------
1. electroretinography (ERG) show progressive loss of photoreceptor function
2.Visual field testing show loss of peripheral vision
3.Flourescin angiography may show dark pigments to establish the presence of Retinitis pigmentosa.
What are the complications of Retinitis pigmentosa?
-------------------------------------------------------
Partial to complete loss of vision.
What is the treatment for Retinitis pigmentosa?
-------------------------------------------------
Retinitis pigmentosa has no cure.
Several methods of treatment aimed at slowing down the progression of loss of vision have been tried:
1.daily intake of 15000 IU of vitamin A palmitate.
2.Retinitis transplants,
3 artificial Retinitis implants,
4.gene therapy,
5.stem cells,
How is Retinitis pigmentosa monitored?
-----------------------------------------
1.regular follow up with the eye doctor.
2.examining the retina for further damage
3.analyzing the visual fields.
What is the prognosis of Retinitis pigmentosa?
----------------------------------------------------
The prognosis is very poor as progression to blindness is the rule.
How can Retinitis pigmentosa be prevented?
-----------------------------------------------
There is no prevention for Retinitis pigmentosa.
The following may help:
1.Genetic counselling
2.Examination of family members for signs of loss of vision
Friday, September 12, 2008
A Simple Guide to Retinal detachment
A Simple Guide to Retinal detachment
----------------------------------------------
What is Retinal detachment?
---------------------------------------
Retinal detachment is a condition in which there is a separation of the neurosensory retina from the underlying retinal pigment epithelium.
It is a medical emergency.
Who is affected by Retinal detachment?
------------------------------------------------
The following are at risk from Retinal detachment:
1. age above 55 yrs
4. very short sighted (myopia usually above 5-6 diopters)
3. history of serious eye injury (injury to orbits)
4. history of eye cataract surgery
5. Sports activities which can cause injuries to the eye (Boxing, karate etc) or increase pressure in the eye( bunjee jumping, diving etc)
6. family history of Retinal detachment -related to family history of diabetes, sickle cell disease and other underlying condition
What is the cause of Retinal detachment?
------------------------------------------------
There are 2 types of retinal detachment:
Primary:
-------------
There is a hole in the retina which allows the seepage of vitreous humor between the the neurosensory retinal layer and the retinal pigment eipthelium which cause the separation of the 2 layers.
The holes are usually at the periphery.
It is a degenerative condition which can be aggravated by trauma especially in the severe myopic(short sighted) and senile (old) eyes.
Secondary:
---------------
Other eye diseases which can separate the 2 layers are:
1.Choroiditis- inflammation of the choroid cause exudation of serous fluid under the retina layer
2.Toxemic retinopathy - inflammation of the retina cause exudation of serous fluid under the retina layer
3.proliferative diabetic retinopathy - abnormal blood vessels grow within the retina causing the retina to pull away from the wall of the eye
4.vitreous hemorrhage after injury to the orbits - blood clot and fibrovasular tissue developing from the blood clot can cause separation of the nuerosensory retina and pigmented retina layer.
5.Choroidal melanoma(a malignant tumor) - a growth below the layers of the retina can push the layer of retina from the back of the eye
What are symptoms and signs of Retinal detachment?
---------------------------------------------------------
Symptoms:
--------------
1.transient flashes of light
2.a sudden increase of floaters in one eye
3.a ring of floaters at the temporal region of the central vision
4.a feeling of heaviness in the eye
5.presence of cloud in front of the eye so that parts of an object are not seen
6.the sensation of a curtain falling over the central vision of eye
7.Straight lines that become curved
8.Central vision intact at first followed by complete and total loss of vision if untreated
Signs:
-----------------
1. In early stage, direct opthalmoscopy show very little abnormality
2. Indirect opthalmoscopy may show the presence of the detachment.
3. The pale white or grey folds of the detachment can be seen
How is Retinal detachment diagnosed?
---------------------------------------------
1. Indirect opthalmoscopy with slit-lamp examination is the best method to detect early or shallow detachment and to identify the retinal holes.
2.Transillumination and ultrasound may be usefulto detect neoplasm
3.Flourescin angiography may be needed in special cases to establish the presence of retinal detachment.
What are the complications of Retinal detachment?
-------------------------------------------------------
Partial to complete loss of vision.
What is the treatment for Retinal detachment?
-------------------------------------------------
Retinal detachment is a medical emergency.
The most important part of treatment is finding the holes or tears and closing them.
Primary:
--------------
1.Vitrectomy (most common procedure)
Vitrectomy involves the removal of the vitreous gel followed by filling the eye with a gas bubble (SF6 or C3F8 gas).
Side effect is the more rapid progression of a cataract in the operated eye.
2.Cryotherapy and Laser Photocoagulation
Cryotherapy (freezing) and laser photocoagulation are used to create a adhesion around the retinal hole so that fluid cannot enter the hole and accumulate behind the retina resulting in the retinal detachment.
3.Adatomed Silicone Oil
Adatomed Silicone Oil is injected into the eye and mechanically holds the retina in place.
The oil is usually removed within a year.
4.Scleral buckle surgery
The choroid and retina are brought together by buckling the sclera with silicone bands sewn by the eye surgeon to the outside of the eyeball.
The most common side effect of this operation is more short sighted after the operation.
5.Pneumatic retinopexy
This operation is done under local anesthesia by injecting a gas bubble (SF6 or C3F8 gas) into the eye after which laser or freezing treatment is applied to the retinal hole. The patient may have to keep his head tilted for several days to keep the gas bubble in contact with the retinal hole in order to seal the hole..
6.Ignipuncture
Ignipuncture involves cauterization of the retina with a very hot pointed instrument.It is no longer used.
After treatment the results are usually good and vision is regained over a period of a few weeks.
Secondary:
----------------
1.Neoplasm: surgical removal of neoplasm
2.Traction detachment: vitreous surgery, prognosis is poor
3.Others:Fluids usually resorbs as underlying condition is treated.
How is Retinal detachment monitored?
-----------------------------------------
1.regular follow up with the eye doctor.
2.examining the retina for further damage
3.analysing the visual fields.
With proper monitoring and treatment most patients will be less likely to be at risk of blindness.
What is the prognosis of Retinal detachment?
----------------------------------------------------
The prognosis varies depending on the the underlying disease.
Prognosis is good if the condition is diagnosed and treated early although visual acuity may not be as good as before.
How can Retina Detachment be prevented?
------------------------------------------
Retinal detachment can be prevented:
1.educating people of the symptoms suggestive of a posterior vitreous detachment.
2.Eye examination to detect retinal tears which can be treated with laser or cryotherapy.
3.Avoid known risk factors for retinal detachment.
a.Cataract surgery
b.Trauma (boxing, kickboxing, karate, etc.)
c.high level of myopia
d.activities that increase pressure in the eye, including diving, skydiving, bungee jumping
----------------------------------------------
What is Retinal detachment?
---------------------------------------
Retinal detachment is a condition in which there is a separation of the neurosensory retina from the underlying retinal pigment epithelium.
It is a medical emergency.
Who is affected by Retinal detachment?
------------------------------------------------
The following are at risk from Retinal detachment:
1. age above 55 yrs
4. very short sighted (myopia usually above 5-6 diopters)
3. history of serious eye injury (injury to orbits)
4. history of eye cataract surgery
5. Sports activities which can cause injuries to the eye (Boxing, karate etc) or increase pressure in the eye( bunjee jumping, diving etc)
6. family history of Retinal detachment -related to family history of diabetes, sickle cell disease and other underlying condition
What is the cause of Retinal detachment?
------------------------------------------------
There are 2 types of retinal detachment:
Primary:
-------------
There is a hole in the retina which allows the seepage of vitreous humor between the the neurosensory retinal layer and the retinal pigment eipthelium which cause the separation of the 2 layers.
The holes are usually at the periphery.
It is a degenerative condition which can be aggravated by trauma especially in the severe myopic(short sighted) and senile (old) eyes.
Secondary:
---------------
Other eye diseases which can separate the 2 layers are:
1.Choroiditis- inflammation of the choroid cause exudation of serous fluid under the retina layer
2.Toxemic retinopathy - inflammation of the retina cause exudation of serous fluid under the retina layer
3.proliferative diabetic retinopathy - abnormal blood vessels grow within the retina causing the retina to pull away from the wall of the eye
4.vitreous hemorrhage after injury to the orbits - blood clot and fibrovasular tissue developing from the blood clot can cause separation of the nuerosensory retina and pigmented retina layer.
5.Choroidal melanoma(a malignant tumor) - a growth below the layers of the retina can push the layer of retina from the back of the eye
What are symptoms and signs of Retinal detachment?
---------------------------------------------------------
Symptoms:
--------------
1.transient flashes of light
2.a sudden increase of floaters in one eye
3.a ring of floaters at the temporal region of the central vision
4.a feeling of heaviness in the eye
5.presence of cloud in front of the eye so that parts of an object are not seen
6.the sensation of a curtain falling over the central vision of eye
7.Straight lines that become curved
8.Central vision intact at first followed by complete and total loss of vision if untreated
Signs:
-----------------
1. In early stage, direct opthalmoscopy show very little abnormality
2. Indirect opthalmoscopy may show the presence of the detachment.
3. The pale white or grey folds of the detachment can be seen
How is Retinal detachment diagnosed?
---------------------------------------------
1. Indirect opthalmoscopy with slit-lamp examination is the best method to detect early or shallow detachment and to identify the retinal holes.
2.Transillumination and ultrasound may be usefulto detect neoplasm
3.Flourescin angiography may be needed in special cases to establish the presence of retinal detachment.
What are the complications of Retinal detachment?
-------------------------------------------------------
Partial to complete loss of vision.
What is the treatment for Retinal detachment?
-------------------------------------------------
Retinal detachment is a medical emergency.
The most important part of treatment is finding the holes or tears and closing them.
Primary:
--------------
1.Vitrectomy (most common procedure)
Vitrectomy involves the removal of the vitreous gel followed by filling the eye with a gas bubble (SF6 or C3F8 gas).
Side effect is the more rapid progression of a cataract in the operated eye.
2.Cryotherapy and Laser Photocoagulation
Cryotherapy (freezing) and laser photocoagulation are used to create a adhesion around the retinal hole so that fluid cannot enter the hole and accumulate behind the retina resulting in the retinal detachment.
3.Adatomed Silicone Oil
Adatomed Silicone Oil is injected into the eye and mechanically holds the retina in place.
The oil is usually removed within a year.
4.Scleral buckle surgery
The choroid and retina are brought together by buckling the sclera with silicone bands sewn by the eye surgeon to the outside of the eyeball.
The most common side effect of this operation is more short sighted after the operation.
5.Pneumatic retinopexy
This operation is done under local anesthesia by injecting a gas bubble (SF6 or C3F8 gas) into the eye after which laser or freezing treatment is applied to the retinal hole. The patient may have to keep his head tilted for several days to keep the gas bubble in contact with the retinal hole in order to seal the hole..
6.Ignipuncture
Ignipuncture involves cauterization of the retina with a very hot pointed instrument.It is no longer used.
After treatment the results are usually good and vision is regained over a period of a few weeks.
Secondary:
----------------
1.Neoplasm: surgical removal of neoplasm
2.Traction detachment: vitreous surgery, prognosis is poor
3.Others:Fluids usually resorbs as underlying condition is treated.
How is Retinal detachment monitored?
-----------------------------------------
1.regular follow up with the eye doctor.
2.examining the retina for further damage
3.analysing the visual fields.
With proper monitoring and treatment most patients will be less likely to be at risk of blindness.
What is the prognosis of Retinal detachment?
----------------------------------------------------
The prognosis varies depending on the the underlying disease.
Prognosis is good if the condition is diagnosed and treated early although visual acuity may not be as good as before.
How can Retina Detachment be prevented?
------------------------------------------
Retinal detachment can be prevented:
1.educating people of the symptoms suggestive of a posterior vitreous detachment.
2.Eye examination to detect retinal tears which can be treated with laser or cryotherapy.
3.Avoid known risk factors for retinal detachment.
a.Cataract surgery
b.Trauma (boxing, kickboxing, karate, etc.)
c.high level of myopia
d.activities that increase pressure in the eye, including diving, skydiving, bungee jumping
Thursday, September 11, 2008
A Simple Guide to Gingivitis
A Simple Guide to Gingivitis
-----------------------------------
What is Gingivitis?
---------------------------
Gingivitis is an acute disease which causes inflammation and infection of the gums with redness, swelling and bleeding.
What are the causes of Gingivitis?
----------------------------------------
Bacterial Infections:
----------------------------
1.Gram positive bacteria such as Streptococcus and Staphphylococcus may be painful and lead to upper respiratory tract infection
2.Gram negative bacteria such as Klebsiella, E.coli, Pseudomonas, Mycobacteria(including tuberculosis), Legionaire's Disease,chlamydia
Non-infectious:
------------------
1.malocclusion
2.food impaction
3.dental calculus
4.dental procedures
5.exposure to heavy metals
6.long term phenytoin treatment
7.Oral contraceptive pills
Systemic diseases:
--------------------
1.diabetes mellitus
2.leukemia
3.Debilitating diseases
4.autoimmune diseases
What are Signs and symptoms of Gingivitis?
---------------------------------------------
Symptoms:
1.Pain in the gums
2.Red swollen inflamed gums
3.bleeding in between the gums
4.Fever may be present
Signs:
1.Red swollen inflamed gums around neck of teeth
2.Swelling of papilla between teeth
3.Gum boils or abscess in the gums
4.Gum ulcers
How is the diagnosis of Gingivitis made?
------------------------------------------
1.Symptoms and signs of red, swollen and inflamed gums
2.blood tests (complete blood count, ESR and blood culture)
3.X-rays of teeth
What are the complications of Gingivitis?
-----------------------------------------------
1.damage to root canals
2.cavity in the teeth
3.upper respiratory tract infection
What is the treatment of Gingivitis?
------------------------------------
1.Rest & fluids
2.Painkiller for pain
3.Antibiotics depending on the organism found:
a.cephalosporin, penicillin, ampicillin, tetracycline, for most streptococci, staphalococci, hemophilus
b.cephalosporins, gentamycin for pseudomonas
4.Oral application of oral antibiotic cream
What is the prognosis of Gingivitis ?
------------------------------------------
Usually very good.
Surgery for abscess and other gum or tooth problem very rarely needed.
What are the Preventive measures taken for Gingivitis ?
--------------------------------------------------------
1.Avoid smoking
2.Healthy lifestyle with balanced diet and exercise.
3.Regular cleaning of gums and teeth by brushing and flossing
4.Gargling of mouth after meals
5.Regular dental checkups
-----------------------------------
What is Gingivitis?
---------------------------
Gingivitis is an acute disease which causes inflammation and infection of the gums with redness, swelling and bleeding.
What are the causes of Gingivitis?
----------------------------------------
Bacterial Infections:
----------------------------
1.Gram positive bacteria such as Streptococcus and Staphphylococcus may be painful and lead to upper respiratory tract infection
2.Gram negative bacteria such as Klebsiella, E.coli, Pseudomonas, Mycobacteria(including tuberculosis), Legionaire's Disease,chlamydia
Non-infectious:
------------------
1.malocclusion
2.food impaction
3.dental calculus
4.dental procedures
5.exposure to heavy metals
6.long term phenytoin treatment
7.Oral contraceptive pills
Systemic diseases:
--------------------
1.diabetes mellitus
2.leukemia
3.Debilitating diseases
4.autoimmune diseases
What are Signs and symptoms of Gingivitis?
---------------------------------------------
Symptoms:
1.Pain in the gums
2.Red swollen inflamed gums
3.bleeding in between the gums
4.Fever may be present
Signs:
1.Red swollen inflamed gums around neck of teeth
2.Swelling of papilla between teeth
3.Gum boils or abscess in the gums
4.Gum ulcers
How is the diagnosis of Gingivitis made?
------------------------------------------
1.Symptoms and signs of red, swollen and inflamed gums
2.blood tests (complete blood count, ESR and blood culture)
3.X-rays of teeth
What are the complications of Gingivitis?
-----------------------------------------------
1.damage to root canals
2.cavity in the teeth
3.upper respiratory tract infection
What is the treatment of Gingivitis?
------------------------------------
1.Rest & fluids
2.Painkiller for pain
3.Antibiotics depending on the organism found:
a.cephalosporin, penicillin, ampicillin, tetracycline, for most streptococci, staphalococci, hemophilus
b.cephalosporins, gentamycin for pseudomonas
4.Oral application of oral antibiotic cream
What is the prognosis of Gingivitis ?
------------------------------------------
Usually very good.
Surgery for abscess and other gum or tooth problem very rarely needed.
What are the Preventive measures taken for Gingivitis ?
--------------------------------------------------------
1.Avoid smoking
2.Healthy lifestyle with balanced diet and exercise.
3.Regular cleaning of gums and teeth by brushing and flossing
4.Gargling of mouth after meals
5.Regular dental checkups
Wednesday, September 10, 2008
A Simple Guide to High Cholesterol
A Simple Guide to High Cholesterol
-------------------------------------------
What is High Cholesterol?
------------------------------
High Cholesterol is the presence of raised amount of total cholesterol in the blood( blood total cholesterol above 200mg/dl).
What is the cause of High Cholesterol?
---------------------------------------------
Cholesterol is a fat molecule in the body which is needed for many normal body functions.
It is produced mostly in the liver and is present in the cell walls and membranes of the brain, nerves, muscles, skin, heart ,intestine and of course liver.
Cholesterol is used by the body to make the body's hormones(male and female) and bile acids used to digest fats.
20-30% of the cholesterol comes from the food that is eaten.
Animal Fat:
-------------
1.A diet high in saturated fat mainly animal fat, butter, lard
2.Trans-fatty acids in fast food and processed foods
Animal organs:
------------------
Brains of pigs, sheep, fish are particularly high in lipoproteins and fat
Liver, skin fat, etc
Egg yolk:
----------------
Egg yolk and products containing egg yolk like fish roe, cakes, icecream,
Dairy Products:
------------------
full cream milk
Certain other food:
--------------------
Peanut butter, peanut oils, coconut oil
Genetic factors - Familial hypercholesterolemia has been known for high cholesterol in families
What is the diagnosis of high cholesterol?
----------------------------------------------------
A blood test for lipid profile measures :
1.total cholesterol
2.LDL (low-density lipoprotein [the bad cholesterol]),
3.HDL (high-density lipoprotein [the good cholesterol])
4. triglycerides—another fatty substance in the blood.
High lipid readings are when the
1.total cholesterol in your blood is more than 200mg/dL,
2.LDL cholesterol is more than 130 mg/dL (130-159 is borderline high; 160 is high; 190 is very high).
3.HDL, the "good cholesterol," should be around 40 mg/dL or greater.
With HDL, the higher the number, the better, and 60 mg/dL is protective against heart disease.
4.Triglycerides is more than 200 mg/dL
What is the danger of High Cholesterol?
------------------------------------------
The excess cholesterol will then be deposited in the arterial walls causing narrowing of the arteries and reducing the blood flow to the heart, kidney and the brain.
Therefore any thickening of the arterial wall of blood vessels to the heart, kidney or brain as a result of deposit of cholesterol deposited in the wall of these arteries will reduce the flow of nutrients and oxygen to the heart, kidney or brain resulting in heart attack, kidney failure or stroke.
What is the Treatment of High Cholesterol?
---------------------------------------------------
1.Dietary and lifestyle modification
2. Medications:
1. statins (HMG-CoA reductase inhibitors) has been found to reduce high cholesterol fairly fast especially the more potent ones such as LIpitor and Crestor.
However they also have more side effects particularly damage to the liver(hepatitis) and muscles(myopathy)
2.fibrates is preferred especially if the triglycerides is high or if the patient has liver problem.
Lipanthyl (a fibrate) has been found to be as effective if not more effective than statins.
Side effects are myopathy.
3.Combination treatment of statins and fibrates are more effective but have more side effects such as increased myopathy and rhabdomyolysis in addition to hepatitis.
4.ezetimibe, niacin, bile acid sequestrants, plant sterol-containing products have also been used together with statins for better effect.
Treatment Regime:
--------------------
1. Total cholesterol is less than 250mg/dl: Diet and weight control is sufficient.
2.Total cholesterol is 250-300mg/dl: Diet and weight control is a must.
If associated risk factors such as high blood pressure, diabetes, heart disease, obesity and smoking is present, drug therapy is necessary.
3:Total cholesterol is more than 300mg/dl:
drug therapy together with diet and weight control is required.
How to prevent High Cholesterol?
-----------------------------------------
Diet Control
-----------------
1. Reduce intake of fatty meats
Eat lean meat and poultry
2. Avoid organs of animals especially liver, brain
Eat more beans, peas or bean cursd
3. Avoid seafood especially prawns, crabs, lobsters,squids'
Take more fish
4. Avoid deep fried food
Take more steamed food and non-creamy soups
5. Avoid lard and butter
Take margarine or polyunsaturated vegetable oils
6. Avoid creams, coconut milk, cakes
Eat Fish oils(omega 3) ,garlic
7. Avoid alcohol, excess rice, jams, sugars, sweets
Eat more fruits and vegetables
Weight control:
---------------------
Reduce the calories in food
Mild to strenous exercise
Avoid stress which can sometimes make you eat more.
-------------------------------------------
What is High Cholesterol?
------------------------------
High Cholesterol is the presence of raised amount of total cholesterol in the blood( blood total cholesterol above 200mg/dl).
What is the cause of High Cholesterol?
---------------------------------------------
Cholesterol is a fat molecule in the body which is needed for many normal body functions.
It is produced mostly in the liver and is present in the cell walls and membranes of the brain, nerves, muscles, skin, heart ,intestine and of course liver.
Cholesterol is used by the body to make the body's hormones(male and female) and bile acids used to digest fats.
20-30% of the cholesterol comes from the food that is eaten.
Animal Fat:
-------------
1.A diet high in saturated fat mainly animal fat, butter, lard
2.Trans-fatty acids in fast food and processed foods
Animal organs:
------------------
Brains of pigs, sheep, fish are particularly high in lipoproteins and fat
Liver, skin fat, etc
Egg yolk:
----------------
Egg yolk and products containing egg yolk like fish roe, cakes, icecream,
Dairy Products:
------------------
full cream milk
Certain other food:
--------------------
Peanut butter, peanut oils, coconut oil
Genetic factors - Familial hypercholesterolemia has been known for high cholesterol in families
What is the diagnosis of high cholesterol?
----------------------------------------------------
A blood test for lipid profile measures :
1.total cholesterol
2.LDL (low-density lipoprotein [the bad cholesterol]),
3.HDL (high-density lipoprotein [the good cholesterol])
4. triglycerides—another fatty substance in the blood.
High lipid readings are when the
1.total cholesterol in your blood is more than 200mg/dL,
2.LDL cholesterol is more than 130 mg/dL (130-159 is borderline high; 160 is high; 190 is very high).
3.HDL, the "good cholesterol," should be around 40 mg/dL or greater.
With HDL, the higher the number, the better, and 60 mg/dL is protective against heart disease.
4.Triglycerides is more than 200 mg/dL
What is the danger of High Cholesterol?
------------------------------------------
The excess cholesterol will then be deposited in the arterial walls causing narrowing of the arteries and reducing the blood flow to the heart, kidney and the brain.
Therefore any thickening of the arterial wall of blood vessels to the heart, kidney or brain as a result of deposit of cholesterol deposited in the wall of these arteries will reduce the flow of nutrients and oxygen to the heart, kidney or brain resulting in heart attack, kidney failure or stroke.
What is the Treatment of High Cholesterol?
---------------------------------------------------
1.Dietary and lifestyle modification
2. Medications:
1. statins (HMG-CoA reductase inhibitors) has been found to reduce high cholesterol fairly fast especially the more potent ones such as LIpitor and Crestor.
However they also have more side effects particularly damage to the liver(hepatitis) and muscles(myopathy)
2.fibrates is preferred especially if the triglycerides is high or if the patient has liver problem.
Lipanthyl (a fibrate) has been found to be as effective if not more effective than statins.
Side effects are myopathy.
3.Combination treatment of statins and fibrates are more effective but have more side effects such as increased myopathy and rhabdomyolysis in addition to hepatitis.
4.ezetimibe, niacin, bile acid sequestrants, plant sterol-containing products have also been used together with statins for better effect.
Treatment Regime:
--------------------
1. Total cholesterol is less than 250mg/dl: Diet and weight control is sufficient.
2.Total cholesterol is 250-300mg/dl: Diet and weight control is a must.
If associated risk factors such as high blood pressure, diabetes, heart disease, obesity and smoking is present, drug therapy is necessary.
3:Total cholesterol is more than 300mg/dl:
drug therapy together with diet and weight control is required.
How to prevent High Cholesterol?
-----------------------------------------
Diet Control
-----------------
1. Reduce intake of fatty meats
Eat lean meat and poultry
2. Avoid organs of animals especially liver, brain
Eat more beans, peas or bean cursd
3. Avoid seafood especially prawns, crabs, lobsters,squids'
Take more fish
4. Avoid deep fried food
Take more steamed food and non-creamy soups
5. Avoid lard and butter
Take margarine or polyunsaturated vegetable oils
6. Avoid creams, coconut milk, cakes
Eat Fish oils(omega 3) ,garlic
7. Avoid alcohol, excess rice, jams, sugars, sweets
Eat more fruits and vegetables
Weight control:
---------------------
Reduce the calories in food
Mild to strenous exercise
Avoid stress which can sometimes make you eat more.
A Simple Guide to Bronchitis
A Simple Guide to Bronchitis
-----------------------------------
What is Bronchitis?
---------------------------
Bronchitis is an acute disease which causes inflammation and infection of the trachea, bronchi and bronchioles of the lungs.
The mucous membranes of the bronchi of the lungs becomes inflamed from bacterial or viral infection or irritated by fumes and dust in the air resulting in swelling of the bronchial mucosa with excess mucous discharge causing narrowing of the air passages.
Because of the congestion of the brochi there is difficulty in breathing and insufficient oxygen to the body thus posing a danger to the patient's life .
What are the causes of Bronchitis?
----------------------------------------
Bacterial Infections:
----------------------------
1.Gram positive bacteria such as Streptococcus Bronchitise and Staphphylococcus may be serious and fatal in some cases.
2.Gram negative bacteria such as Klebsiella, E.coli, Pseudomonas, Mycobacteria(including tuberculosis), Legionaire's Disease,chlamydia
Viral infections:
--------------------
Influenza, arbovirus, Severe Acute Respiratory Syndrome(SARS) virus, coxsackie virus
Fungal infections:
-----------------------
Cryptococcus neoformans
Non-infectious:
------------------
1.chemicals such as fumes can damage the lungs and cause Bronchitis
2.Othostatic Bronchitis occurs in people who are bedridden and are unable to get rid of the fluids accumulated in their lungs
3.Aspiration Bronchitis occurs with saliva or fluids in the throat become sucked into the windpipe and the lungs.
This occurs in comatose patients and people having seizures or stroke.
What are Signs and symptoms of Bronchitis?
---------------------------------------------
Symptoms:
1.cold or runny nose is usually the first symptom
2.Fever may be present
3.cough initially dry, followed by productive purulent sputum which can yellow, green or bloody
4.Breathlessness due to airway obstruction
5.chest pain especially the sides of the chest due to coughing and fever
6.Myalgia (bodyaches) and headache which may be related to the fever
Signs:
1.Moist sounds and wheezing on auscultation with sthetoscope due to narrowing of the airways(bronchi)
2.rhonchi or wheezing sounds due to narrowing of the airways from pressure in the congested lungs
3.Reduced breath sounds - air movement is reduced in the lungs
4.Hyporesonance on percussion of the lungs
5.Cyanosis(blue color) of the lips and fingers if not enough oxygen is entering.
This will considered as a medical emergency.
Children and babies with Bronchitis may not have signs of a chest infection.
They are however quite ill, with fever and lethargy.
How is the diagnosis of Bronchitis made?
------------------------------------------
1.Symptoms and signs of fever, breathless and productive cough
2.blood tests (complete blood count, ESR and blood culture)
3.Sputum culture to determine the type of micro-organism
4.Chest X-rays to establish site and character of the bronchial infection
5.CT or MRI of the lungs may be done if required especailly if there is suspicion of lung cancer.
What are the complications of Bronchitis?
-----------------------------------------------
1.Pneumonia
2.adult respiratory distress syndrome
3.Emphysema
What is the treatment of Bronchitis?
------------------------------------
1.Rest, fluids and oxygen
2.Bronchidilators such as aminophylline, ventolin, bricanyl
3.Antibiotics depending on the organism found:
a.cephalosporin, penicillin, ampicillin, tetracycline, for most streptococci, staphalococci, hemophilus
b.cephalosporins, gentamycin for pseudomonas
c.Tetracycline or erythromycin for mycoplasma and chlamydia
d.Erythromycin and rifampicin for Legionaire's disease.
3.Antivirals such as Tamiflu for Influeza infection
Acyclovir may be given for herpes virus infection
4.High dosages of antifungals may be given for Fungal Bronchitis for a prolonged period of time
5.corticosteroids is useful to reduce complications
6.Humidifiers and steam inhalations
5.cough mixtures and mucolytic agents such as bisolvon
What is the prognosis of Bronchitis ?
------------------------------------------
This depends on the severity and type of infection.
Most cases if treated early and correctly recovered completely with return of normal lung function.
In elderly and debilitated patients, breathing can be a problem and recurrence can occur.
What are the Preventive measures taken for Bronchitis ?
--------------------------------------------------------
1.Avoid smoking and dusty environment.
2.Healthy lifestyle with balanced diet and exercise.
3.Vaccination against the influenza virus may help.
-----------------------------------
What is Bronchitis?
---------------------------
Bronchitis is an acute disease which causes inflammation and infection of the trachea, bronchi and bronchioles of the lungs.
The mucous membranes of the bronchi of the lungs becomes inflamed from bacterial or viral infection or irritated by fumes and dust in the air resulting in swelling of the bronchial mucosa with excess mucous discharge causing narrowing of the air passages.
Because of the congestion of the brochi there is difficulty in breathing and insufficient oxygen to the body thus posing a danger to the patient's life .
What are the causes of Bronchitis?
----------------------------------------
Bacterial Infections:
----------------------------
1.Gram positive bacteria such as Streptococcus Bronchitise and Staphphylococcus may be serious and fatal in some cases.
2.Gram negative bacteria such as Klebsiella, E.coli, Pseudomonas, Mycobacteria(including tuberculosis), Legionaire's Disease,chlamydia
Viral infections:
--------------------
Influenza, arbovirus, Severe Acute Respiratory Syndrome(SARS) virus, coxsackie virus
Fungal infections:
-----------------------
Cryptococcus neoformans
Non-infectious:
------------------
1.chemicals such as fumes can damage the lungs and cause Bronchitis
2.Othostatic Bronchitis occurs in people who are bedridden and are unable to get rid of the fluids accumulated in their lungs
3.Aspiration Bronchitis occurs with saliva or fluids in the throat become sucked into the windpipe and the lungs.
This occurs in comatose patients and people having seizures or stroke.
What are Signs and symptoms of Bronchitis?
---------------------------------------------
Symptoms:
1.cold or runny nose is usually the first symptom
2.Fever may be present
3.cough initially dry, followed by productive purulent sputum which can yellow, green or bloody
4.Breathlessness due to airway obstruction
5.chest pain especially the sides of the chest due to coughing and fever
6.Myalgia (bodyaches) and headache which may be related to the fever
Signs:
1.Moist sounds and wheezing on auscultation with sthetoscope due to narrowing of the airways(bronchi)
2.rhonchi or wheezing sounds due to narrowing of the airways from pressure in the congested lungs
3.Reduced breath sounds - air movement is reduced in the lungs
4.Hyporesonance on percussion of the lungs
5.Cyanosis(blue color) of the lips and fingers if not enough oxygen is entering.
This will considered as a medical emergency.
Children and babies with Bronchitis may not have signs of a chest infection.
They are however quite ill, with fever and lethargy.
How is the diagnosis of Bronchitis made?
------------------------------------------
1.Symptoms and signs of fever, breathless and productive cough
2.blood tests (complete blood count, ESR and blood culture)
3.Sputum culture to determine the type of micro-organism
4.Chest X-rays to establish site and character of the bronchial infection
5.CT or MRI of the lungs may be done if required especailly if there is suspicion of lung cancer.
What are the complications of Bronchitis?
-----------------------------------------------
1.Pneumonia
2.adult respiratory distress syndrome
3.Emphysema
What is the treatment of Bronchitis?
------------------------------------
1.Rest, fluids and oxygen
2.Bronchidilators such as aminophylline, ventolin, bricanyl
3.Antibiotics depending on the organism found:
a.cephalosporin, penicillin, ampicillin, tetracycline, for most streptococci, staphalococci, hemophilus
b.cephalosporins, gentamycin for pseudomonas
c.Tetracycline or erythromycin for mycoplasma and chlamydia
d.Erythromycin and rifampicin for Legionaire's disease.
3.Antivirals such as Tamiflu for Influeza infection
Acyclovir may be given for herpes virus infection
4.High dosages of antifungals may be given for Fungal Bronchitis for a prolonged period of time
5.corticosteroids is useful to reduce complications
6.Humidifiers and steam inhalations
5.cough mixtures and mucolytic agents such as bisolvon
What is the prognosis of Bronchitis ?
------------------------------------------
This depends on the severity and type of infection.
Most cases if treated early and correctly recovered completely with return of normal lung function.
In elderly and debilitated patients, breathing can be a problem and recurrence can occur.
What are the Preventive measures taken for Bronchitis ?
--------------------------------------------------------
1.Avoid smoking and dusty environment.
2.Healthy lifestyle with balanced diet and exercise.
3.Vaccination against the influenza virus may help.
Monday, September 8, 2008
A Simple Guide to Thyroid Nodules
A Simple Guide to Thyroid Nodules
-----------------------------------
What are Thyroid Nodules ?
------------------------------------------------
Thyroid nodules are abnormal swellings in the thyroid gland which occurs when the thyroid tissues starts to proliferate in one part of the thyroid gland.
Who are at risk of thyroid nodule?
-------------------------------------
1.Thyroid nodules are more common in females than in male.
2.However the thyroid nodule in males are more prone to malignancy than in females
3.Thyroid nodules occurs more in the 30- 60 age group.
What are the different types of Thyroid Nodules?
--------------------------------------------------------------
1.solid - solid thyroid nodules which may or not feel hard
2.cystic - the nodules is filled with fluid.
3.benign - non malignant
4.malignant - cancerous
What are the symptoms and signs of Thyroid Nodules?
-------------------------------------------------------
In mild cases there is usually no obvious symptoms.
In moderate or severe cases of thyroid nodules:
Symptoms:
--------------
1.Obvious swelling in the thyroid gland
2.Neck swelling -suuggest presence of spread to the lymph node
3.Hoarseness of voice may occur if there is pressure on the vocal cord or recurrent nerve to vocal cord
4.Dyspnea or breathlessness if there is pressure on the trachea
5.Dysphagia or difficuly in swallowing due to pressure on the oesophagus
Signs:
-------------
1.Thyroid nodules are felt only if they are more than 1.5 to 2cm in diameter.
2.Cystic nodules may feel hard while solid nodules may be soft to firm.
3. The vocal cords should always be examined to exclude lesions in the vocal cords causing hoarseness.
4.Malignant thyroid nodules present similarly to benign nodules but can spread to other parts of the body.
How are diagnosis of Thyroid Nodules made?
------------------------------------------------------------
1.blood test for thyroxine and TSH levels
2.fine needle aspiration biopsy is a simple way to determine if a nodule is benign or malignant.
The biopsied material is then sent to the lab for tests to look for any malignant cells.
3.ultrasound scans are done to differentiate between solid and cystic nodules,
4.thyroid scans which help to show if a nodule is producing excessive thyroid hormone(hot) or not.
5.CT Scan or MRI are not routine to thyroid nodules investigation except where there is suspected compression of teachea.
What is the Treatment of Thyroid Nodules?
-------------------------------------------
Benign lumps can be monitored by doctors at regular intervals.
If there are symptoms of compressing a neighbouring organ or the nodule is cancerous, surgery is required.
Patients who has symptoms of hyperthyroidism are advised to go for radioactive iodine treatment or surgery.
What is the Prognosis of Thyroid Nodules?
-------------------------------------------
Prognosis is good in all benign cases.
Malignant thyroid nodules will depend on any spread to other organs.
-----------------------------------
What are Thyroid Nodules ?
------------------------------------------------
Thyroid nodules are abnormal swellings in the thyroid gland which occurs when the thyroid tissues starts to proliferate in one part of the thyroid gland.
Who are at risk of thyroid nodule?
-------------------------------------
1.Thyroid nodules are more common in females than in male.
2.However the thyroid nodule in males are more prone to malignancy than in females
3.Thyroid nodules occurs more in the 30- 60 age group.
What are the different types of Thyroid Nodules?
--------------------------------------------------------------
1.solid - solid thyroid nodules which may or not feel hard
2.cystic - the nodules is filled with fluid.
3.benign - non malignant
4.malignant - cancerous
What are the symptoms and signs of Thyroid Nodules?
-------------------------------------------------------
In mild cases there is usually no obvious symptoms.
In moderate or severe cases of thyroid nodules:
Symptoms:
--------------
1.Obvious swelling in the thyroid gland
2.Neck swelling -suuggest presence of spread to the lymph node
3.Hoarseness of voice may occur if there is pressure on the vocal cord or recurrent nerve to vocal cord
4.Dyspnea or breathlessness if there is pressure on the trachea
5.Dysphagia or difficuly in swallowing due to pressure on the oesophagus
Signs:
-------------
1.Thyroid nodules are felt only if they are more than 1.5 to 2cm in diameter.
2.Cystic nodules may feel hard while solid nodules may be soft to firm.
3. The vocal cords should always be examined to exclude lesions in the vocal cords causing hoarseness.
4.Malignant thyroid nodules present similarly to benign nodules but can spread to other parts of the body.
How are diagnosis of Thyroid Nodules made?
------------------------------------------------------------
1.blood test for thyroxine and TSH levels
2.fine needle aspiration biopsy is a simple way to determine if a nodule is benign or malignant.
The biopsied material is then sent to the lab for tests to look for any malignant cells.
3.ultrasound scans are done to differentiate between solid and cystic nodules,
4.thyroid scans which help to show if a nodule is producing excessive thyroid hormone(hot) or not.
5.CT Scan or MRI are not routine to thyroid nodules investigation except where there is suspected compression of teachea.
What is the Treatment of Thyroid Nodules?
-------------------------------------------
Benign lumps can be monitored by doctors at regular intervals.
If there are symptoms of compressing a neighbouring organ or the nodule is cancerous, surgery is required.
Patients who has symptoms of hyperthyroidism are advised to go for radioactive iodine treatment or surgery.
What is the Prognosis of Thyroid Nodules?
-------------------------------------------
Prognosis is good in all benign cases.
Malignant thyroid nodules will depend on any spread to other organs.
Sunday, September 7, 2008
A Simple Guide to Otitis media
A Simple Guide to Otitis media
----------------------------------------------------
What is Otitis media?
---------------------------------------
Otitis media is acute or chronic inflammation of the middle ear.
Otitis media occurs in the area between the ear drum (the end of the outer ear) and the inner ear, including a duct known as the Eustachian tube.
Who is affected by Otitis media?
---------------------------------------------------
1.childhood, usually related to viral upper respiratory tract infection
2.family history of middle ear disease.
What are the Causes of Otitis media?
-----------------------------------------------------
Bacterial infections:
1.Streptococcus pneumoniae
2.Haemophilus influenzae
3.staphylococcus aureus
4.Moraxella catarrhalis, a gram-negative diplococcus.
5.Mycobacterium tuberculosis.
6.E.coli
Viral infections:
1.common cold.
2.measles
What is the Types of Otitis Media?
-----------------------------------------------------
1. Acute otitis media
Acute otitis media ia an acute infection of the middle ear which usually occurs as a result of viral upper respiratory tract infection that can occur at least twice a year
2.Chronic otitis media
Chronic otitis media occurs following acute otitis media with chronic infection of the middle ear and ear perforation.
3.Otitis media with effusion:
Otitis media with effusion occurs when fluid occurs in the middle ear due to blockage of the eustachian tube.
What are the complications of Otitis media?
---------------------------------------------------
1.mastoiditis
2.labrynthitis
3.facial nerve palsy
4.meningitis,
5.brain abscess,
6.febrile seizures.
7.death if a severe infection goes untreated long enough
What are the Symptoms and signs of Otitis media?
-----------------------------------------------------------
1. cold: stuffy nose
2. earache - The pain lasts a day or two.
3. high fever - may cause seizures if very high
4. discharging pus from the ruptured eardrum
Usually the ruptured drum will usually heal spontaneously
5.Eustachian tube becomes blocked resulting in hearing loss
Signs:
1.Ear drum (tympanic membrane) inflamed and bulging with loss of normal outline
2.Decreased or displaced light reflex of ear drum
3.perforation of ear drum
4.mucopurulent discharge from ear after perforation
How is diagnosis of Otitis media made?
-----------------------------------------------
1.Inflamed ear drum with loss of normal outline, decreased light reflex, bulging and perforation and purulent discharge.
2.Culture and sensitivity of pus swab
3.Nasal and pharyngeal swabs my also be done
4.X-rays or MRI of the mastoid air cells
5.Audiogram for hearing loss
What is the treatment of Otitis media?
---------------------------------------------------
Acute otitis media
1. Antibiotics may be commenced if fever is high or the culture showed bacterial infections.
2.Fever and pain may be treated with paracetamol
3.Antihistamines may be given for rhinitis or runny nose.
4.Decogestants may be necessary for blockage of eustachian tube
5.Bed rest and Fluids
6.Myringoplasty -Puncture of bulging ear drum if painful and aspiration of pus or fluid in the middle ear.
7.Tympanoplasty for eardrum whose perforation does not heal.
8.Mastoidectomy to remove cholesteatoma(growing of skin into middle ear cavity) in chronic otitis media with mastoiditis.
What is the prognosis of Otitis media?
-----------------------------------------
Prognosis with appropriate treatment is generally good.
Ear drum perforation usually heal spontaneously in most cases.
What are Preventive measures for Otitis media?
----------------------------------------------------
Avoid swimming and diving.
Proper ear hygiene.
----------------------------------------------------
What is Otitis media?
---------------------------------------
Otitis media is acute or chronic inflammation of the middle ear.
Otitis media occurs in the area between the ear drum (the end of the outer ear) and the inner ear, including a duct known as the Eustachian tube.
Who is affected by Otitis media?
---------------------------------------------------
1.childhood, usually related to viral upper respiratory tract infection
2.family history of middle ear disease.
What are the Causes of Otitis media?
-----------------------------------------------------
Bacterial infections:
1.Streptococcus pneumoniae
2.Haemophilus influenzae
3.staphylococcus aureus
4.Moraxella catarrhalis, a gram-negative diplococcus.
5.Mycobacterium tuberculosis.
6.E.coli
Viral infections:
1.common cold.
2.measles
What is the Types of Otitis Media?
-----------------------------------------------------
1. Acute otitis media
Acute otitis media ia an acute infection of the middle ear which usually occurs as a result of viral upper respiratory tract infection that can occur at least twice a year
2.Chronic otitis media
Chronic otitis media occurs following acute otitis media with chronic infection of the middle ear and ear perforation.
3.Otitis media with effusion:
Otitis media with effusion occurs when fluid occurs in the middle ear due to blockage of the eustachian tube.
What are the complications of Otitis media?
---------------------------------------------------
1.mastoiditis
2.labrynthitis
3.facial nerve palsy
4.meningitis,
5.brain abscess,
6.febrile seizures.
7.death if a severe infection goes untreated long enough
What are the Symptoms and signs of Otitis media?
-----------------------------------------------------------
1. cold: stuffy nose
2. earache - The pain lasts a day or two.
3. high fever - may cause seizures if very high
4. discharging pus from the ruptured eardrum
Usually the ruptured drum will usually heal spontaneously
5.Eustachian tube becomes blocked resulting in hearing loss
Signs:
1.Ear drum (tympanic membrane) inflamed and bulging with loss of normal outline
2.Decreased or displaced light reflex of ear drum
3.perforation of ear drum
4.mucopurulent discharge from ear after perforation
How is diagnosis of Otitis media made?
-----------------------------------------------
1.Inflamed ear drum with loss of normal outline, decreased light reflex, bulging and perforation and purulent discharge.
2.Culture and sensitivity of pus swab
3.Nasal and pharyngeal swabs my also be done
4.X-rays or MRI of the mastoid air cells
5.Audiogram for hearing loss
What is the treatment of Otitis media?
---------------------------------------------------
Acute otitis media
1. Antibiotics may be commenced if fever is high or the culture showed bacterial infections.
2.Fever and pain may be treated with paracetamol
3.Antihistamines may be given for rhinitis or runny nose.
4.Decogestants may be necessary for blockage of eustachian tube
5.Bed rest and Fluids
6.Myringoplasty -Puncture of bulging ear drum if painful and aspiration of pus or fluid in the middle ear.
7.Tympanoplasty for eardrum whose perforation does not heal.
8.Mastoidectomy to remove cholesteatoma(growing of skin into middle ear cavity) in chronic otitis media with mastoiditis.
What is the prognosis of Otitis media?
-----------------------------------------
Prognosis with appropriate treatment is generally good.
Ear drum perforation usually heal spontaneously in most cases.
What are Preventive measures for Otitis media?
----------------------------------------------------
Avoid swimming and diving.
Proper ear hygiene.
Friday, September 5, 2008
A Simple Guide to Skin warts
A Simple Guide to Skin warts
----------------------------------------------------
What are Skin warts?
---------------------------------------
Skin warts are benign epithelial hyperplasia raised swellings on the skin caused by one of the human papilloma viruses.
They are infectious by direct contact or indirect contact through contaminated surfaces from one person to the other.
It is the one of the common skin condition.
It is never life threatening.
Who is affected by Skin warts?
---------------------------------------------------
Skin warts is more common in :
1.children than in adults
2.contact with a person with warts
3.families with a patient having warts
What is the Cause of Skin warts?
-----------------------------------------------------
The human papilloma virus is the cause of skin warts.
There are 100 types of HPV which has been identified as causing skin or mucosal infections.
What are the types of Skin warts?
-----------------------------------------------------------
Common wart:
--------------
Common warts are benign swellings in the skin that are caused by human papillomavirus (HPV) infection.
1.Periungual wart
Periungual warts are common warts around or under the fingernail and toenail.
2.Plantar warts
Plantar warts are found on the pressure areas of the foot.
The presure causes inward growth.
They can be single, seedling or mosaic.
3.Mosaic warts
Mosaic warts are plagues of closely set plantar warts
4.Plane warts
Plane warts are flat-topped smooth papules, light brown or skin flesh in color present on the face, legs, and hands often occuring in large numbers.
5.Filiform warts
Filiform warts appear as a single long narrow growth often on the eyelid or face
What are the Symptoms and signs of Skin warts?
-----------------------------------------------------------
Skin warts can present as:
1.round or irregular raised swelling
2.Color may be like normal skin or light brown.
3.Surface is rough(may look like califlower) or smooth
4.Border is sharply demarcated
5.Size varies from 2-10mm in diameter.
5.They are usually found on the fingers, elbows, knees, feet, scalp and face.
How do you make the Diagnosis of Skin warts?
------------------------------------------------------------
1.Skin biopsy under local anesthesia
2.small lesions can be totally removed
3.larger ones are biopsied first and surgically removed later on
What are the complications of Skin warts?
--------------------------------------------------------
If skin warts are transmitted to the genital area, there is a risk of genital warts which can cause cervical cancer in women
What is the treatment of Skin warts?
---------------------------------------------------
Many warts resolve spontaneously.
For those that persists or grow bigger, other treatments may be used:
1.Surgery:
Skin warts are removed by surgical excision.
2.Chemical treatment:
a.local therapy with Salicylic-acid preparations which dissolves the protein forming most of both the wart and the thick layer of dead skin above it.
b. 5-fluorouracil(a chemotherapy agent)
3.Cautery:
Electrotherapy by cautery of the warts kills the virus and destroy the tisues underneath which allow them to grow.
4.Cryosurgery:
Aerosol wart treatments freeze warts at a temperature of minus 57 C.
This can kill the virus.
Dermatologists use liquid nitrogen which is considerably colderminus 196 C.
What is the prognosis of Skin warts?
----------------------------------------------------
Prognosis of majority of cases is good if there is complete removal.
Recurrences are common
What are the preventive measures for Skin warts?
-----------------------------------------------------------------
Avoid direct or indirect contact through contaminated surfaces with people having warts
----------------------------------------------------
What are Skin warts?
---------------------------------------
Skin warts are benign epithelial hyperplasia raised swellings on the skin caused by one of the human papilloma viruses.
They are infectious by direct contact or indirect contact through contaminated surfaces from one person to the other.
It is the one of the common skin condition.
It is never life threatening.
Who is affected by Skin warts?
---------------------------------------------------
Skin warts is more common in :
1.children than in adults
2.contact with a person with warts
3.families with a patient having warts
What is the Cause of Skin warts?
-----------------------------------------------------
The human papilloma virus is the cause of skin warts.
There are 100 types of HPV which has been identified as causing skin or mucosal infections.
What are the types of Skin warts?
-----------------------------------------------------------
Common wart:
--------------
Common warts are benign swellings in the skin that are caused by human papillomavirus (HPV) infection.
1.Periungual wart
Periungual warts are common warts around or under the fingernail and toenail.
2.Plantar warts
Plantar warts are found on the pressure areas of the foot.
The presure causes inward growth.
They can be single, seedling or mosaic.
3.Mosaic warts
Mosaic warts are plagues of closely set plantar warts
4.Plane warts
Plane warts are flat-topped smooth papules, light brown or skin flesh in color present on the face, legs, and hands often occuring in large numbers.
5.Filiform warts
Filiform warts appear as a single long narrow growth often on the eyelid or face
What are the Symptoms and signs of Skin warts?
-----------------------------------------------------------
Skin warts can present as:
1.round or irregular raised swelling
2.Color may be like normal skin or light brown.
3.Surface is rough(may look like califlower) or smooth
4.Border is sharply demarcated
5.Size varies from 2-10mm in diameter.
5.They are usually found on the fingers, elbows, knees, feet, scalp and face.
How do you make the Diagnosis of Skin warts?
------------------------------------------------------------
1.Skin biopsy under local anesthesia
2.small lesions can be totally removed
3.larger ones are biopsied first and surgically removed later on
What are the complications of Skin warts?
--------------------------------------------------------
If skin warts are transmitted to the genital area, there is a risk of genital warts which can cause cervical cancer in women
What is the treatment of Skin warts?
---------------------------------------------------
Many warts resolve spontaneously.
For those that persists or grow bigger, other treatments may be used:
1.Surgery:
Skin warts are removed by surgical excision.
2.Chemical treatment:
a.local therapy with Salicylic-acid preparations which dissolves the protein forming most of both the wart and the thick layer of dead skin above it.
b. 5-fluorouracil(a chemotherapy agent)
3.Cautery:
Electrotherapy by cautery of the warts kills the virus and destroy the tisues underneath which allow them to grow.
4.Cryosurgery:
Aerosol wart treatments freeze warts at a temperature of minus 57 C.
This can kill the virus.
Dermatologists use liquid nitrogen which is considerably colderminus 196 C.
What is the prognosis of Skin warts?
----------------------------------------------------
Prognosis of majority of cases is good if there is complete removal.
Recurrences are common
What are the preventive measures for Skin warts?
-----------------------------------------------------------------
Avoid direct or indirect contact through contaminated surfaces with people having warts
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