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
Showing posts with label headache. Show all posts
Showing posts with label headache. Show all posts
Thursday, September 18, 2008
Wednesday, September 10, 2008
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, August 18, 2008
A Simple Guide to Pneumonia
A Simple Guide to Pneumonia
-----------------------------------
What is Pneumonia?
---------------------------
Pneumonia is a serious medical disease which causes inflammation and infection of the lung tissues of one or both lungs.
The alveoli of the lungs are filled with exudates and white blood cells sent by the body to contain the infection.
Because of the congestion of the lungs there is difficulty in breathing and insufficient oxygen to the body thus posing a danger to the patient's life .
It is one of the top causes of death in the world.
What are the causes of Pneumonia?
----------------------------------------
Bacterial Infections:
----------------------------
1.Gram positive bacteria such as Streptococcus pneumoniae and Staphylococcus 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
Mycobacterium tuberculosis pneumonia are more common in developing countries and in people whose immune systems are impaired(e.g. AIDS) and are preceded by active tuberculosis infections elsewhere.
Viral infections:
--------------------
Influenza, arbovirus, Severe Acute Respiratory Syndrome(SARS) virus, coxsackie virus
Fungal infections:
-----------------------
Cryptococcus neoformans
Non-infectious:
------------------
1.chemicals such as asbestos can damage the lungs and cause pneumonia
2.Othostatic pneumonia occurs in people who are bedridden and are unable to get rid of the fluids accumulated in their lungs
3.Aspiration pneumonia 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 pneumonia?
---------------------------------------------
Symptoms:
1.cold or runny nose is usually the first symptom
2.Fever is usually high
3.cough with productive purulent sputum which can yellow, green or bloody
4.Breathlessness due to congestion of the lungs
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
7.abdominal discomfort
8.lethargy especially in small children
Signs:
1.creptitation sounds on auscultation with stethoscope due to large amount of phlegm in the alveoli of the lungs
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 pneumonia may not have signs of a chest infection.
They are however quite ill, with fever and lethargy.
Elderly people also do not have much symptoms except for fever and breathlessness
How is the diagnosis of Pneumonia made?
------------------------------------------
1.Symptoms and signs of fever, breathless and productive cough
2.blood tests (complete blood count, ESR and blood culture) including viral and legionaire's disease
3.Sputum culture to determine the type of micro-organism
4.Chest X-rays to establish site and character of the lung infection
5.Pleural tap may be necessary if there is pleural effusion. The pleural aspirate is then sent for culture and microscopic examination.
6.CT or MRI of the lungs may be done if required especailly if there is suspicion of lung cancer.
What are the complications of Pneumonia?
-----------------------------------------------
1.Pleural effusion
2.septic shock,
3.adult respiratory distress syndrome
4.seizures also more in children
5.Emphysema
6.Pericarditis
What is the treatment of pneumonia?
------------------------------------
1.Hospitalization should be immediate as pneumonia can be a life threatening condition.
2.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 Influenza infection
Acyclovir may be given for herpes virus infection
4.High dosages of anti-fungals may be given for Fungal pneumonia for a prolonged period of time
3.corticosteroids is useful to reduce complications
4.High-flow oxygen
5.intravenous fluids
What is the prognosis of pneumonia ?
------------------------------------------
This depends on the severity and type of infection.
Most cases if treated early and correctly recovered completely.
The elderly, babies and bedridden has a higher mortality.
What are the Preventive measures taken for pneumonia ?
--------------------------------------------------------
Vaccinations against Haemophilus influenzae in children and adults has reduced the incidence of this form of pneumonia.
Pneumococcal vaccine against Streptococcus pneumoniae has been given to newborns to prevent pneumonia.
Vaccinations are recommended in:
Adults age 65 or older
Patient over two years of age
1. with diseased lungs, heart, liver, or kidneys
2. health problems like diabetes, alcoholism, AIDS
3. taking any medications or therapy that can affect the body's immune system
e.g chemotherapy
-----------------------------------
What is Pneumonia?
---------------------------
Pneumonia is a serious medical disease which causes inflammation and infection of the lung tissues of one or both lungs.
The alveoli of the lungs are filled with exudates and white blood cells sent by the body to contain the infection.
Because of the congestion of the lungs there is difficulty in breathing and insufficient oxygen to the body thus posing a danger to the patient's life .
It is one of the top causes of death in the world.
What are the causes of Pneumonia?
----------------------------------------
Bacterial Infections:
----------------------------
1.Gram positive bacteria such as Streptococcus pneumoniae and Staphylococcus 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
Mycobacterium tuberculosis pneumonia are more common in developing countries and in people whose immune systems are impaired(e.g. AIDS) and are preceded by active tuberculosis infections elsewhere.
Viral infections:
--------------------
Influenza, arbovirus, Severe Acute Respiratory Syndrome(SARS) virus, coxsackie virus
Fungal infections:
-----------------------
Cryptococcus neoformans
Non-infectious:
------------------
1.chemicals such as asbestos can damage the lungs and cause pneumonia
2.Othostatic pneumonia occurs in people who are bedridden and are unable to get rid of the fluids accumulated in their lungs
3.Aspiration pneumonia 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 pneumonia?
---------------------------------------------
Symptoms:
1.cold or runny nose is usually the first symptom
2.Fever is usually high
3.cough with productive purulent sputum which can yellow, green or bloody
4.Breathlessness due to congestion of the lungs
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
7.abdominal discomfort
8.lethargy especially in small children
Signs:
1.creptitation sounds on auscultation with stethoscope due to large amount of phlegm in the alveoli of the lungs
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 pneumonia may not have signs of a chest infection.
They are however quite ill, with fever and lethargy.
Elderly people also do not have much symptoms except for fever and breathlessness
How is the diagnosis of Pneumonia made?
------------------------------------------
1.Symptoms and signs of fever, breathless and productive cough
2.blood tests (complete blood count, ESR and blood culture) including viral and legionaire's disease
3.Sputum culture to determine the type of micro-organism
4.Chest X-rays to establish site and character of the lung infection
5.Pleural tap may be necessary if there is pleural effusion. The pleural aspirate is then sent for culture and microscopic examination.
6.CT or MRI of the lungs may be done if required especailly if there is suspicion of lung cancer.
What are the complications of Pneumonia?
-----------------------------------------------
1.Pleural effusion
2.septic shock,
3.adult respiratory distress syndrome
4.seizures also more in children
5.Emphysema
6.Pericarditis
What is the treatment of pneumonia?
------------------------------------
1.Hospitalization should be immediate as pneumonia can be a life threatening condition.
2.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 Influenza infection
Acyclovir may be given for herpes virus infection
4.High dosages of anti-fungals may be given for Fungal pneumonia for a prolonged period of time
3.corticosteroids is useful to reduce complications
4.High-flow oxygen
5.intravenous fluids
What is the prognosis of pneumonia ?
------------------------------------------
This depends on the severity and type of infection.
Most cases if treated early and correctly recovered completely.
The elderly, babies and bedridden has a higher mortality.
What are the Preventive measures taken for pneumonia ?
--------------------------------------------------------
Vaccinations against Haemophilus influenzae in children and adults has reduced the incidence of this form of pneumonia.
Pneumococcal vaccine against Streptococcus pneumoniae has been given to newborns to prevent pneumonia.
Vaccinations are recommended in:
Adults age 65 or older
Patient over two years of age
1. with diseased lungs, heart, liver, or kidneys
2. health problems like diabetes, alcoholism, AIDS
3. taking any medications or therapy that can affect the body's immune system
e.g chemotherapy
Friday, August 15, 2008
A Simple Guide to Meningitis
A Simple Guide to Meningitis
-----------------------------------
What is Meningitis?
---------------------------
Meningitis is a serious medical disease which causes inflammation and infection of the meninges which are the protective lining of the spinal cord and brain.
What are the causes of Meningitis?
----------------------------------------
The causes of Meningitis may be divided into:
Infections:
------------
1.viral infections are the most common and are usually mild
(enterovirus, herpes simplex virus 2 and mumps) except for Hand mouth and foot disease(enterovirus EV7)which can cause fatality in children
2.bacterial infections such as meningoccocus (Neisseria meningitidis) and pneumococcus (Streptococcus pneumoniae) can be serious and fatal in some cases.
Meningococcal meningitis can cause outbreaks(spread easily).
E.coli, Group B streptococus and Pseudomonas infection are common in neonates.
Neisseria meningitidis, Haemophilus influenzae, Streptococcus pneumoniae are common in infants and children
Streptococcus pneumoniae, N. meningitidis, Mycobacteria are more common in adults.
Mycobacterium tuberculosis meningitis are more common in developing countries and in people whose immune systems are impaired(eg. AIDS) and are preceded by active tuberculosis infections elsewhere.
3.fungi
Cryptococcus neoformans is the most common cause of fungal meningitis
Non-infectious:
------------------
Non infectious causes usually irritates the meninges through inflammation and auto immune reactions:
1.cancers,
2.systemic lupus erythematosus
3.drugs.
4.head injury
5.post neurosurgical procedures
What are Signs and symptoms of Meningitis?
---------------------------------------------
The triad of symptoms which often defines meningitis are:
1.Severe headache
2.Neck rigidity (unable to flex the neck forward),
A positive Kernig's sign means that the neck will painful when one hip is flexed to 90 degrees and the knee flexed to 90 degrees in a patient lying supine.
3.vomiting
Other symptoms are:
4.high fever
5.mental confusion.
6.Malaise
7.photo-phobia (inability to tolerate bright light),
8.phono-phobia (inability to tolerate loud noises),
9.irritability especially in small children
10.seizures .
11.swelling of the fontanelle may be present in infants
12.rash with numerous small, irregular red spots on the body, lower legs, soles of feet, palms
13.ulcers of the mouth (present in hand,mouth and foot disease).
How is the diagnosis of Meningitis made?
------------------------------------------
1.Classical symptoms and signs as above especially neck rigidity
2.blood tests (complete blood count, ESR and blood culture)
3.X-rays of chest and brain
4.cerebrospinal fluid (CSF) analysis via lumbar puncture is examined for white blood cells, red blood cells, protein content, glucose level and micro-organisms.
This test should not be done if there is suspected cerebral mass lesion or raised intracranial pressure (head injury, localizing neurological signs)
A pressure of over 180 mm suggests bacterial meningitis.
5.CSF glucose is low,protein high and cells high in bacterial meningitis,
CSF glucose is normal,protein normal and cells high in viral meningitis
CSF glucose is low,protein high and cells high in fungal meningitis
6.CT or MRI of the brain and spine with MRI preferred over CT because it can detect more easily areas of cerebral edema,tumors, ischemia, and meningeal inflammation.
What are the complications of Meningitis?
-----------------------------------------------
1.Neurological deficits
2.deafness
3.learning disorders in children
4.brain infarction,
5.septic shock,
6.adult respiratory distress syndrome
7.seizures also more in children
8.pneumonia especially in the elderly
What is the treatment of Meningitis?
------------------------------------
1.Hospitalization should be immediate as meningitis is an life threatening condition.
2.Antibiotics such as cephalosporin, ampicillin, chloramphenicol, intravenous vancomycin to be started even before doing lumbar puncture.
Acyclovir may be given for herpes virus infection
High dosages of anti-fungals may be given for Fungal meningitis for a prolonged period of time
3.corticosteroids is useful to reduce complications
4.High-flow oxygen
5.intravenous fluids
What is the prognosis of Meningitis?
------------------------------------------
This depends on the severity and type of infection.
Viral infections except for enterovirus EV7 usually recover quickly.
Bacterial infections such as meningococcus and pneumococcus are more dangerous.
What are the Preventive measures taken for Meningitis?
--------------------------------------------------------
Vaccinations against Haemophilus influenzae in children and adults has reduced the incidence of this form of meningitis.
Vaccines against type A and C Neisseria meningitidis are used to prevent these types of meningitis especially in those who travel abroad.
Vaccines against type B Neisseria meningitidis have yet to be produced athough a drug company is doing research on the production of this vaccine.
Pneumococcal vaccine against Streptococcus pneumoniae has been given to newborns to prevent pneumococcal meningitis.
Mumps vaccination as part of Measles, mumps and rubella vaccine(MMR) has reduced the incidence of mumps related form of meningitis
-----------------------------------
What is Meningitis?
---------------------------
Meningitis is a serious medical disease which causes inflammation and infection of the meninges which are the protective lining of the spinal cord and brain.
What are the causes of Meningitis?
----------------------------------------
The causes of Meningitis may be divided into:
Infections:
------------
1.viral infections are the most common and are usually mild
(enterovirus, herpes simplex virus 2 and mumps) except for Hand mouth and foot disease(enterovirus EV7)which can cause fatality in children
2.bacterial infections such as meningoccocus (Neisseria meningitidis) and pneumococcus (Streptococcus pneumoniae) can be serious and fatal in some cases.
Meningococcal meningitis can cause outbreaks(spread easily).
E.coli, Group B streptococus and Pseudomonas infection are common in neonates.
Neisseria meningitidis, Haemophilus influenzae, Streptococcus pneumoniae are common in infants and children
Streptococcus pneumoniae, N. meningitidis, Mycobacteria are more common in adults.
Mycobacterium tuberculosis meningitis are more common in developing countries and in people whose immune systems are impaired(eg. AIDS) and are preceded by active tuberculosis infections elsewhere.
3.fungi
Cryptococcus neoformans is the most common cause of fungal meningitis
Non-infectious:
------------------
Non infectious causes usually irritates the meninges through inflammation and auto immune reactions:
1.cancers,
2.systemic lupus erythematosus
3.drugs.
4.head injury
5.post neurosurgical procedures
What are Signs and symptoms of Meningitis?
---------------------------------------------
The triad of symptoms which often defines meningitis are:
1.Severe headache
2.Neck rigidity (unable to flex the neck forward),
A positive Kernig's sign means that the neck will painful when one hip is flexed to 90 degrees and the knee flexed to 90 degrees in a patient lying supine.
3.vomiting
Other symptoms are:
4.high fever
5.mental confusion.
6.Malaise
7.photo-phobia (inability to tolerate bright light),
8.phono-phobia (inability to tolerate loud noises),
9.irritability especially in small children
10.seizures .
11.swelling of the fontanelle may be present in infants
12.rash with numerous small, irregular red spots on the body, lower legs, soles of feet, palms
13.ulcers of the mouth (present in hand,mouth and foot disease).
How is the diagnosis of Meningitis made?
------------------------------------------
1.Classical symptoms and signs as above especially neck rigidity
2.blood tests (complete blood count, ESR and blood culture)
3.X-rays of chest and brain
4.cerebrospinal fluid (CSF) analysis via lumbar puncture is examined for white blood cells, red blood cells, protein content, glucose level and micro-organisms.
This test should not be done if there is suspected cerebral mass lesion or raised intracranial pressure (head injury, localizing neurological signs)
A pressure of over 180 mm suggests bacterial meningitis.
5.CSF glucose is low,protein high and cells high in bacterial meningitis,
CSF glucose is normal,protein normal and cells high in viral meningitis
CSF glucose is low,protein high and cells high in fungal meningitis
6.CT or MRI of the brain and spine with MRI preferred over CT because it can detect more easily areas of cerebral edema,tumors, ischemia, and meningeal inflammation.
What are the complications of Meningitis?
-----------------------------------------------
1.Neurological deficits
2.deafness
3.learning disorders in children
4.brain infarction,
5.septic shock,
6.adult respiratory distress syndrome
7.seizures also more in children
8.pneumonia especially in the elderly
What is the treatment of Meningitis?
------------------------------------
1.Hospitalization should be immediate as meningitis is an life threatening condition.
2.Antibiotics such as cephalosporin, ampicillin, chloramphenicol, intravenous vancomycin to be started even before doing lumbar puncture.
Acyclovir may be given for herpes virus infection
High dosages of anti-fungals may be given for Fungal meningitis for a prolonged period of time
3.corticosteroids is useful to reduce complications
4.High-flow oxygen
5.intravenous fluids
What is the prognosis of Meningitis?
------------------------------------------
This depends on the severity and type of infection.
Viral infections except for enterovirus EV7 usually recover quickly.
Bacterial infections such as meningococcus and pneumococcus are more dangerous.
What are the Preventive measures taken for Meningitis?
--------------------------------------------------------
Vaccinations against Haemophilus influenzae in children and adults has reduced the incidence of this form of meningitis.
Vaccines against type A and C Neisseria meningitidis are used to prevent these types of meningitis especially in those who travel abroad.
Vaccines against type B Neisseria meningitidis have yet to be produced athough a drug company is doing research on the production of this vaccine.
Pneumococcal vaccine against Streptococcus pneumoniae has been given to newborns to prevent pneumococcal meningitis.
Mumps vaccination as part of Measles, mumps and rubella vaccine(MMR) has reduced the incidence of mumps related form of meningitis
Sunday, November 11, 2007
A Simple Guide to Cerebral aneurysm
A Simple Guide to Cerebral aneurysm
---------------------------------------------
What is Cerebral aneurysm?
-----------------------------------
A cerebral aneurysm is an abnormal ballooning of a section of a blood vessel in the brain.
What is the causes of cerebral aneurysm?
--------------------------------------------------
Cerebral aneurysms occur when there is a weakened area in the wall of a blood vessel in the brain.
1.They may occur as a congenital (before birth) defect or may develop later in life.
About 5% of the population has some form of aneurysm in the brain.
2.Trauma and infection, which can injure the blood vessel wall, can cause such aneurysms.
What are the Symptoms of cerebral aneurysm?
---------------------------------------------------------
Cerebral aneurysm usually cause no symptoms until they rupture and cause bleeding into the brain.
Often, an aneurysm is found when a CT scan or MRI is performed for another reason. If the unruptured swollen aneurysm presses on the brain , it can cause the following symptoms:
1.Headaches
2.Eye pain
3.Neck pain
4.Double vision
5.Loss of vision
Symptoms of an aneurysm that have ruptured are:
1.Sudden occurrence of a severe headache (often described as "worst headache of my life")
2.Headaches with nausea or vomiting
3.Stiff neck
4.Muscle weakness, difficulty moving any part of the body
5.Numbness or decreased sensation in any part of the body
6.Vision changes like blurring of vision,double vision
7.Eyelid drooping
8.Confusion,
9. Sudden onset of irritability, impulsivity, or poor temper control
10.Slow, sluggish movement
11.Speech impairment
12.Seizures
A ruptured aneurysm is a medical emergency.
What are the investigations done in cerebral aneurysm?
------------------------------------------------------------------
The following tests may be used to diagnose cerebral aneurysm:
1.CT scan of the head can identify bleeding and usually locate the aneurysm.
2.MRI of the head may be an alternative to a CT scan but may be as good at showing bleeding in the brain.
3.Cerebral angiography or spiral CT scan angiography of the head is used to pinpoint the location and size of the aneurysm.
4.cerebrospinal fluid examination via a spinal tap may confirm bleeding.
5.EEG (electroencephalogram) should be performed if there are seizures.
What is the Treatment of cerebral aneurysm?
--------------------------------------------------------
Symptoms often do not appear until bleeding of a cerebral aneurysm occurs.
A ruptured cerebral aneurysm is an emergency condition.
The goal of treatment is to prevent further bleeding.
Lowering of blood pressure can decrease the risk of further bleeding.
Neurosurgery is the primary treatment for cerebral aneurysm.
The base of the aneurysm is closed off with clamps or sutures.
Special coils or stents can be placed into the aneurysm through the arteries to prevent rupture.
A blood clot then forms in the aneurysm and prevents further bleeding. This is considered a less invasive approach than brain surgery. It is regarded as the best form of treatment.
If surgery is not feasible because of the location or size of the aneurysm or the condition of the person, medical treatment is:
1.restricting activity (often complete bedrest is advised),
2.treating symptoms such as headache,
3.controlling blood pressure, and
4.prescribing of antiseizure medications.
After the aneurysm is repaired, prevention of stroke due to blood vessel spasm is necessary. This may include intravenous fluids, certain medications, and controlling the blood pressure.
What is the Prognosis of cerebral aneurysm?
-----------------------------------------------------
The prognosis depends on the severity of the condition.
Ruptured cerebral aneurysms are often serious.
In severe cases, about 25% of people die within 1 day, and another 25% die within about 3 months. Of those who survive, more than half will have some sort of permanent disability.
In small leaks of ruptured cerebral aneurysm, early treatment of the condition can be very effective with little loss of neurological deficit.
Unruptured aneurysms can be treated very effectively before causing problems.
The decision to repair an unruptured cerebral aneurysm is based on the size and location of the aneurysm, and the patient's age and general health.
What are the Possible Complications of cerebral aneurysm?
----------------------------------------------------------------------
1.Subarachnoid hemorrhage
2.Stroke
3.Seizures, epilepsy
4.Paralysis of any part of the body
5.Permanent loss of sensation of any part of the face or body
6.Other neurologic deficits (such as vision changes, loss of speech ability, cognitive decline)
What is the Prevention of cerebral aneurysm?
---------------------------------------------------------
There is no known way to prevent the formation of a cerebral aneurysm because most of them are congenital.
If sudden or severe headache occurs, particularly if you also have nausea, vomiting, seizures, or any other neurological symptoms, early admission to hospital and appropriate investigation can detect an unruptured aneurym or one which has just started to bleed.
Treatment can be initiated and prognosis is good.
Sunday, November 4, 2007
A Simple Guide to Fever
A Simple Guide to Fever
-----------------------------
What is Fever?
-----------------
A person's normal body temperature is 37.0 degrees Celsius.
Once above this, it is classified as a fever.
Fever is a symptom not an illness.
What is the cause of Fever?
---------------------------------
A Person's body temperature can be influenced by factors such as
1. infection,
2. metabolic rate and
3.environmental temperature.
When any infection entered the body and localised in a part of the body such as the throat ,intestine, nose, urinary tract etc, it does not cause any fever, only symptoms such as sore throat, diarrhoea, nasal discharge or frequent passing of urine.
However once the germ(whether bacteria,virus or parasite) enter the blood stream from the infected area, the body responses immediately by raising the body temperature.
The raising of the body temperature is the body's way of trying to kill the germ by heating the environment which the germ is trying to survive.
High fevers (above 39 degrees Celsius) however can also damage the body especially the brain.
It can cause seizures in children below the age of five (febrile fits).
Toxins from bacteria and viruses released into the bloodstream can cause chills and shivering in between or sometimes during temperature spikes.
What are the Symptoms of Fever?
----------------------------------------
1. Headache
2. Bodyaches
3. Chills
4. Shivering
5. Giddiness
6. Loss of appetite
What is the Treatment of Fever?
--------------------------------------
Fever is the body's natural response to a infection, increase in the temperature of the environment and increased metabolic rate.
If the fever is mild (<37.5)and no other problems are present, no medical treatment is necessary.
Just drink more water and rest.
Sponging or bathing in a tub of tepid water can help to reduce the fever. Evaporation of the water cools the skin and thereby reduces body temperature.
Give the person a correct amount of paracetamol which helps to bring down the temperature.
You should see a doctor:
1.If a child of less than 6 months old has a fever.
2.If a fever of more than 39 Degree Celsius cannot be brought down by paracetamol and sponging.
3.If fever lasts for more than 5 days.
4.If there is associated stiff neck and vomiting
5.If there is drowsiness or loss of consciousness
Once the cause of the fever is found and eliminated, the body temperature will reduce spontaneously back to normal.
-----------------------------
What is Fever?
-----------------
A person's normal body temperature is 37.0 degrees Celsius.
Once above this, it is classified as a fever.
Fever is a symptom not an illness.
What is the cause of Fever?
---------------------------------
A Person's body temperature can be influenced by factors such as
1. infection,
2. metabolic rate and
3.environmental temperature.
When any infection entered the body and localised in a part of the body such as the throat ,intestine, nose, urinary tract etc, it does not cause any fever, only symptoms such as sore throat, diarrhoea, nasal discharge or frequent passing of urine.
However once the germ(whether bacteria,virus or parasite) enter the blood stream from the infected area, the body responses immediately by raising the body temperature.
The raising of the body temperature is the body's way of trying to kill the germ by heating the environment which the germ is trying to survive.
High fevers (above 39 degrees Celsius) however can also damage the body especially the brain.
It can cause seizures in children below the age of five (febrile fits).
Toxins from bacteria and viruses released into the bloodstream can cause chills and shivering in between or sometimes during temperature spikes.
What are the Symptoms of Fever?
----------------------------------------
1. Headache
2. Bodyaches
3. Chills
4. Shivering
5. Giddiness
6. Loss of appetite
What is the Treatment of Fever?
--------------------------------------
Fever is the body's natural response to a infection, increase in the temperature of the environment and increased metabolic rate.
If the fever is mild (<37.5)and no other problems are present, no medical treatment is necessary.
Just drink more water and rest.
Sponging or bathing in a tub of tepid water can help to reduce the fever. Evaporation of the water cools the skin and thereby reduces body temperature.
Give the person a correct amount of paracetamol which helps to bring down the temperature.
You should see a doctor:
1.If a child of less than 6 months old has a fever.
2.If a fever of more than 39 Degree Celsius cannot be brought down by paracetamol and sponging.
3.If fever lasts for more than 5 days.
4.If there is associated stiff neck and vomiting
5.If there is drowsiness or loss of consciousness
Once the cause of the fever is found and eliminated, the body temperature will reduce spontaneously back to normal.
Saturday, November 3, 2007
A Simple Guide to Headache
A Simple Guide to Headache
---------------------------------
What is Headache?
----------------------
Headache is a very common complaint, not an illness.
It literally means pain in the head.
What are the Common Types of Headaches?
--------------------------------------------------
Tension headache:
-----------------
as defined by the International Headache Society is characterised by:
1.bilateral location
2.pressing/tightening (non-pulsating) quality
3. mild to moderate in intensity
4. not aggravated by routine physical activity like walking or climbing stairs.
It is the most common headache and may be associated with contractions of head and neck muscles due to physical or mental stress. The headache is made worse by changes in the environment, drugs, or factors unique to the individual.
It can also be classified into 2 side types:
episodic (<>
chronic (> 14 days a month on average and <>
Treatment can be divided into:
pharmaceutical
non pharmaceutical
Pharmaceutial:
can be divided into acute and prophylactic.
In acute treament simple painkillers is usually effective.
In prophylactive treatment,antidepressants like amitriptyline usually help in the prevention of tension headache.
Medicines should always be given at low doses and titrated up to therapeutic doses to minimise side effects.
Non-pharmaceutical:
1. rest
2. removal of aggravating factors.
3. relaxation exercises
Migraine:
-----------
is defined as a heavy throbbing pain usually over one side of the scalp, forehead and about the eye, caused by abnormally dilated blood vessels.
Migraine may be accompanied by nausea, vomiting or sensitivity to loud noises or bright lights.
It is also triggered by certain factors unique to the individual such as:
1.menstruation,
2.alcohol,
3.anxiety,
4.loud noises,
5.bright lights
A validated 3 items questionaire covering
1. disability
2. nausea
3. sensitivity to lights
should given to every patient to screen the severity of the migraine.
Treatment again is divided into:
phamaceutical
non-pharmaceutical.
Pharmacetical:
can be divided into acute and prophylactic.
In acute treament simple painkillers like paracetamol is usually effective in mild cases.
Non-steroidal anti-inflamatory drugs should be tried if paracetamol fails.
If NSAIDs are ineffective then migraine-specific drugs like triptans or ergotamine which act to constrict blood vessel should be tried.
In some cases anti-emetic drugs like stemetil to prevent vomiting is given together with the migraine medication.
In prophylactic treatment, the goals are to:
1. reduce frequency,severity and duration
2.improve function and reduce disability
3.improve responsiveness to treatment of acute attacks
Medicines used include:
betablockers
Calcium channel blockers
Serotonin receptor antagonists
Antidressants
Anticonvulsants
Angiotensin blockers
NSAIDs
Non-pharmaceuticals:
1.resting in a cool, dark and quiet room.
2.relaxation exercises
3.Solving the triggering factors also help.
4.Oestogen containing oral cotraceptives should avoided in menstrual migraine.
During pregnancy or lactation treatment should be non-pharmaceutical when possible. If necessary paracetamol is the safest drug for women during pregnancy or lactation.
Cluster headaches
----------------------
is defined as pain which occurs in runs with tearing pain over the forehead or behind the eye(s) with flushing of the face.
There are aura of stars,flashing lights etc associated with this headache.
The cause is beleived to be due to histamine release from ingestion of certain foods like cheese, seafood,alcohol etc.
It is more common in males.
Treatment is by
1.strong painkillers
2.avoidance of food triggers
3.rest.
What are Secondary headaches?
---------------------------------------
It is diagnosed by its close relation to a disorder that is known to cause headache.
The headache improves or disappear after successful treatment or spontaneous resolution of the causative illness.
1.Sinus headaches:
----------------------
are due to acute sinus inflammation attacks.
Pain is over the frontal forehead and the upper cheeks.
It may be associated with fever and heavy mucus production.
Treatment is by
1.antibiotics for the sinus infection,
2.antihistamines to reduce mucus production
3.painkillers
4.rest.
2.Referred headaches:
---------------------------
these are caused by by referred pain from disorders of structures around the head. Common ones are
1. earaches,
2. toothache causing pain over an entire part of the face and
3. temporomandibular joint dysfunction from mechanical pain from the jaw joint.
4. temporal arteritis, a rare inflammatory blood vessel condition causing persistent headache at the temporal artery. There is possible complication of blindness secondary to anterior ischemic optic neuropathy. The headache usually resolves or improves with 3 days of high dose steroid treatment.
3.Meningitis / Encephalitis headaches:
---------------------------------------------
caused by infection of the brain tissue (encephalitis) or the membranes surrounding the brain (meningitis).
Headache is the most common symptom. The pain is diffuse and progressive with fever, a painful stiff neck and other symptoms such as drowsiness, seizures and neurological problems including weakness and numbness.
This type of headache needs immediate hospital treatment.
4.Cerebrovascular Accidents (haemorrhagic stroke):
-------------------------------------------------------------
a stroke happens when a blood vessel in the brain is blocked or bursts.
Bleeding in the brain causes a sudden severe headache.
There is also associated loss of consciousness and other neurological signs such as weakness, numbness and seizures.
This type of headache needs immediate hospital treatment.
5.Brain Tumour:
------------------
is rare and causes a gradual headache lasting for weeks.
It is localised and associated with nausea, vomiting, loss of appetite and loss of weight.
It is worse in the morning and aggravated by coughing or leaning forward.
By the time neurological symptoms appear such as seizures, numbness, weakness or blindness, the brain tumour has already grown to an advanced stage.
Treatment includes surgery, chemotherapy or radiotherapy.
6. Other causes of secondary headaches are:
a.post traumatic headache following a head injury
b.whiplash injury
c.cerebral venous thrombosis
d. idiopathic intracranial hypertension
e. hydrocephalus
f. sleep apnea
g.cardiac cephalgia
h.acute glaucoma
Simple Treatment of Headache
-------------------------------------
Consume a painkiller.
Lie down in a dark, quiet room.
Use muscle relaxation techniques or a gentle massage.
For tension headaches, try a warm bath.
For migraines, put an ice bag or cold towel on your temple.
If the headache do not improve, go for a complete investigation of the headache.
What are the investigations done in Headache?
-------------------------------------------------------
You should be investigated for your headache if the headache has:
1. associated fever and and change in mental state.
2. numbness of part of the body or with paralysis.
3. associated fits.
4. sudden onset of severe headache
5. lasted for more than a day even after taking painkillers.
6. increased headache frequency.
7. appeared different from your usual type
8. been precipitated by coughing,sneezing,bending
9. associated with stiff neck and vomiting
10.appeared for the first time in middle age
Common tests:
Blood tests - for infections,raised ESR, bleeding disease
MRI of brain- to exclude brain tumours, bleeding in the brain
Lumbar puncture - used only if there is suspected infection of brain or meninges
Monday, October 8, 2007
A Simple guide to Stress
A Simple guide to Stress
----------------------------
What is Stress?
-----------------
Stress is a very common condition characterised by exaggerated worry and tension.
People with stress worry excessively about money, health, family, or work, even though there are no signs of trouble.
They are unable to relax and may suffer from insomnia.
What are the common warning signs of stress?
------------------------------------------------------
The signs vary from person to person.
Some of them are:
1. Headaches
2. fast heartbeats
3. Muscle tension; muscle aches
4. muscle tremors
5. Inability to concentrate
6. Stomach ache
7. Diarrhoea
8. Chest pain
9. Breathlessness; hyperventilation
10.Dry mouth
11.Excessive sweating
12.Cold clammy hands
13.Under eating or overeating
14.Anxiety or panic
15.Irritability
16.Hyperactivity
17.Loss of sex drive
18.Fatigue
19.Sense of impending doom
20.Difficulty in falling asleep or frequent nightmares
Other signs may include chills, thirst, dizziness, nausea, fainting, twitches, vomiting, weakness, stuttering,shaky and strained voice,high-pitch laughter and higher blood pressure.
Even for children of school-going age, there are stress.
Symptoms include:
1.Fear of being away from the family
2.Refusal to go to school
3.Fear of strangers
4.Fear of falling asleep or having recurrent nightmares
5.Unnecessary worry
What can we do to lower our stress level?
------------------------------------------------
There are some ways to manage Stress:
1.Be more organised.
Plan your time well.
Do a list of all the things you need to do.
Arrange them in order of importance.
Decide how much time you need for each job.
Keep to your plan.
2.Give yourself time to adjust from one change to another.
Spread out the changes in your life.
Don't do too many things at one time.
3.Always do your work according to your own ability and interest.
Be realistic about what you can do.
Do not ask for the impossible.
Set goals which are achievable so that you don't feel frustrated or discouraged.
4.Think before making decisions.
Get all the relevant information first.
Don't decide blindly.
Consider all the pros and cons of each choice.
Get the people who will be affected by the decision involved in the process.
5.Learn to like yourself.
Don't worry about your external appearance and other faults.
Make the best of what you have.
Accept what you cannot change.
6.AlwaysThink positively.
Prevent negative feelings from building up.
Try to find the source of these feelings.
Always deal constructively with them.
Do not blow things out of proportion.
7.Do not keep all your problems and worries to yourself.
Remember you are not alone.
Share your problems with your spouse, friend or supervisor .
They may have had experience with similar situations.
They may be able to solve your problem.
8.Always build a happy family.
Be kind and loving to your family.
They will provide you with love and support in your times of need.
Always set aside some time each day to talk, play or relax together.
Your home should be a happy place to return to after a hard day's work.
9.Have good friends.
You also need good friends to talk to and laugh with.
They will visit you, go out with you and help you in times of need.
Treat others the way you would like them to treat you.
Respect their views and be patient with their faults.
Always try to give and take.
10.A healthy body is important to overcome stress.
Keep healthy by exercising regularly, eating wisely and getting enough sleep.
Do not smoke or drink to relieve your stress.
Smoking and drinking do not solve anything.
They will cause more problems for your health.
11.Spend some time on yourself.
Do something that you really enjoy like a hobby or an exercise.
Take a short break when you feel tensed or tired.
You deserve to have a little fun sometimes.
12.Try to learn some Relaxation Techniques:
Deep breathing exercise,
meditation,
massage and
muscle relaxation techniques
can be helpful in relieving stress.
What is the Treatment of Stress?
---------------------------------------
Stress can be treated with conventional medicine, psychotherapy and alternative approaches.
A combination of conventional and alternative methods has been shown to be effective.
Conventional Medicine
Psychotherapy and psychoanalysis helps to identify the buried conflicts and worries that may be causing the stress.
Behaviour modification, on the other hand, focuses on changing patterns of behaviour to help the patient avert stress or to cope better with it.
Cognitive therapy similarly concentrates on changing ways of thinking.
One of the best forms of treatment for stress is daily exercise and a healthy lifestyle.
Medication relieves symptoms of stress and is often prescribed in conjunction with other therapies.
Alternative Medicine:
--------------------------
music therapy,
yoga,
herbs and
aromatherapy
are some ways that have helped stress sufferers to relax.
"Remember that you are not alone.
There are always people who are willing to help you.
In this life you must always give and take.
Be happy! Don't worry unnnecessarily!"
----------------------------
What is Stress?
-----------------
Stress is a very common condition characterised by exaggerated worry and tension.
People with stress worry excessively about money, health, family, or work, even though there are no signs of trouble.
They are unable to relax and may suffer from insomnia.
What are the common warning signs of stress?
------------------------------------------------------
The signs vary from person to person.
Some of them are:
1. Headaches
2. fast heartbeats
3. Muscle tension; muscle aches
4. muscle tremors
5. Inability to concentrate
6. Stomach ache
7. Diarrhoea
8. Chest pain
9. Breathlessness; hyperventilation
10.Dry mouth
11.Excessive sweating
12.Cold clammy hands
13.Under eating or overeating
14.Anxiety or panic
15.Irritability
16.Hyperactivity
17.Loss of sex drive
18.Fatigue
19.Sense of impending doom
20.Difficulty in falling asleep or frequent nightmares
Other signs may include chills, thirst, dizziness, nausea, fainting, twitches, vomiting, weakness, stuttering,shaky and strained voice,high-pitch laughter and higher blood pressure.
Even for children of school-going age, there are stress.
Symptoms include:
1.Fear of being away from the family
2.Refusal to go to school
3.Fear of strangers
4.Fear of falling asleep or having recurrent nightmares
5.Unnecessary worry
What can we do to lower our stress level?
------------------------------------------------
There are some ways to manage Stress:
1.Be more organised.
Plan your time well.
Do a list of all the things you need to do.
Arrange them in order of importance.
Decide how much time you need for each job.
Keep to your plan.
2.Give yourself time to adjust from one change to another.
Spread out the changes in your life.
Don't do too many things at one time.
3.Always do your work according to your own ability and interest.
Be realistic about what you can do.
Do not ask for the impossible.
Set goals which are achievable so that you don't feel frustrated or discouraged.
4.Think before making decisions.
Get all the relevant information first.
Don't decide blindly.
Consider all the pros and cons of each choice.
Get the people who will be affected by the decision involved in the process.
5.Learn to like yourself.
Don't worry about your external appearance and other faults.
Make the best of what you have.
Accept what you cannot change.
6.AlwaysThink positively.
Prevent negative feelings from building up.
Try to find the source of these feelings.
Always deal constructively with them.
Do not blow things out of proportion.
7.Do not keep all your problems and worries to yourself.
Remember you are not alone.
Share your problems with your spouse, friend or supervisor .
They may have had experience with similar situations.
They may be able to solve your problem.
8.Always build a happy family.
Be kind and loving to your family.
They will provide you with love and support in your times of need.
Always set aside some time each day to talk, play or relax together.
Your home should be a happy place to return to after a hard day's work.
9.Have good friends.
You also need good friends to talk to and laugh with.
They will visit you, go out with you and help you in times of need.
Treat others the way you would like them to treat you.
Respect their views and be patient with their faults.
Always try to give and take.
10.A healthy body is important to overcome stress.
Keep healthy by exercising regularly, eating wisely and getting enough sleep.
Do not smoke or drink to relieve your stress.
Smoking and drinking do not solve anything.
They will cause more problems for your health.
11.Spend some time on yourself.
Do something that you really enjoy like a hobby or an exercise.
Take a short break when you feel tensed or tired.
You deserve to have a little fun sometimes.
12.Try to learn some Relaxation Techniques:
Deep breathing exercise,
meditation,
massage and
muscle relaxation techniques
can be helpful in relieving stress.
What is the Treatment of Stress?
---------------------------------------
Stress can be treated with conventional medicine, psychotherapy and alternative approaches.
A combination of conventional and alternative methods has been shown to be effective.
Conventional Medicine
Psychotherapy and psychoanalysis helps to identify the buried conflicts and worries that may be causing the stress.
Behaviour modification, on the other hand, focuses on changing patterns of behaviour to help the patient avert stress or to cope better with it.
Cognitive therapy similarly concentrates on changing ways of thinking.
One of the best forms of treatment for stress is daily exercise and a healthy lifestyle.
Medication relieves symptoms of stress and is often prescribed in conjunction with other therapies.
Alternative Medicine:
--------------------------
music therapy,
yoga,
herbs and
aromatherapy
are some ways that have helped stress sufferers to relax.
"Remember that you are not alone.
There are always people who are willing to help you.
In this life you must always give and take.
Be happy! Don't worry unnnecessarily!"
Tuesday, August 21, 2007
A Simple Guide to Glaucoma
A Simple Guide to Glaucoma
----------------------------------
----------------------------------
What is Glaucoma?
-----------------------
-----------------------
Glaucoma is a condition in which there is an increase in the pressure in the eye.
Because of the increase of this intraocular pressure, the nerve that connects the eye to the brain(the optic nerve) may be damaged.
This can result in decreased peripheral vision and, eventually, blindness.
Who is affected by Glaucoma?
----------------------------------
Who is affected by Glaucoma?
----------------------------------
The following are at risk from Glaucoma:
1. age above 65 yrs
2. family history of glaucoma
3.history of serious eye injury or eye surgery
4.very short sighted
5. long term usage of steroid-containing eye drops
6. Diabetes
What is the cause of Glaucoma?
--------------------------------------
1. age above 65 yrs
2. family history of glaucoma
3.history of serious eye injury or eye surgery
4.very short sighted
5. long term usage of steroid-containing eye drops
6. Diabetes
What is the cause of Glaucoma?
--------------------------------------
The pressure in the eye (Intraocular pressure) is increased when there is poor drainage of the fluid that flows in and out of the anterior chamber of the eye.
The higher pressure can then cause damage to the nerve.
What are symptoms of Glaucoma?
----------------------------------------
What are symptoms of Glaucoma?
----------------------------------------
There are two major types of glaucoma:
1.Chronic Glaucoma( or Primary open angle Glaucoma )is sometimes referred to as a "silent thief of eyesight".
This is because it progress slowly and does not produce any symptom until it is very advanced. By that time irreversible damage of the optic nerve may have occured causing blurring of vision.
2.A less common form of Glaucoma known as acute closed angled Glaucoma causes sudden symptoms of intense eye pain, headaches, haloes around lights, dilated pupils, vision loss, red eyes, nausea and vomiting.
2.A less common form of Glaucoma known as acute closed angled Glaucoma causes sudden symptoms of intense eye pain, headaches, haloes around lights, dilated pupils, vision loss, red eyes, nausea and vomiting.
These signs may last for a few hours, then return again for another round. Each attack takes with it part of your field of vision. This requires emergency treatment.
Other variations include
3.congenital glaucoma:
It's difficult to spot signs for congenital glaucoma because the children are too young to understand. If you notice a cloudy, white, hazy, enlarged or protruding eye, consult your eye doctor
4. pigmentary glaucoma:
Pigmentary glaucoma often exhibits no symptoms at all. You may notice some pain and blurry vision after exercise. Pigmentary glaucoma affects mostly males in their mid-30s to mid-40s.
5.secondary glaucoma:
Symptoms of chronic glaucoma following an eye injury could indicate secondary glaucoma.
How is Glaucoma diagnosed?
----------------------------------
Glaucoma is diagnosed using specialised instruments.
These may show:
Raised intraocular pressure(in most cases)
Your eye pressure (intraocular pressure) will be measured with a tonometer. Some tonometers blow a puff of air onto your eye's surface.
Other variations include
3.congenital glaucoma:
It's difficult to spot signs for congenital glaucoma because the children are too young to understand. If you notice a cloudy, white, hazy, enlarged or protruding eye, consult your eye doctor
4. pigmentary glaucoma:
Pigmentary glaucoma often exhibits no symptoms at all. You may notice some pain and blurry vision after exercise. Pigmentary glaucoma affects mostly males in their mid-30s to mid-40s.
5.secondary glaucoma:
Symptoms of chronic glaucoma following an eye injury could indicate secondary glaucoma.
How is Glaucoma diagnosed?
----------------------------------
Glaucoma is diagnosed using specialised instruments.
These may show:
Raised intraocular pressure(in most cases)
Your eye pressure (intraocular pressure) will be measured with a tonometer. Some tonometers blow a puff of air onto your eye's surface.
damaged optic nerve
abnormal visual fields
How does Intraocular pressure occur in Glaucoma?
-------------------------------------------------------------
An increased IOP reading indicates a problem with the amount of aqueous humor (fluid) in the eye:
either the eye is producing too much fluid, or
it's not draining properly.
The drainage area is the angle formed between the cornea and the iris, which is why you see the word "angle" in the different glaucoma names.
Narrow-angle glaucoma occurs in less than 10% of glaucoma patients. In this form of the disease, aqueous humor cannot drain out of the eye due to very narrow drainage angles that are usually blocked by the iris. This condition can occur slowly and progressively, or very quickly.
Rapid closing of the angles, or acute angle-closure glaucoma, is a medical emergency. Optic nerve damage and vision loss will occur within hours if the angles are not opened to drain fluid and lower IOP.
Congenital glaucoma is a rare form of the disease affecting babies.
These children are born with narrow angles or some other defect in the drainage system of the eye.
Pigmentary glaucoma is caused by pigment from the iris clogging the draining angles, preventing aqueous humor from leaving the eye.
Secondary glaucoma develops after trauma to the eye that affects the drainage system. Injury, infection, inflammation, tumor or an enlarged cataract can precipitate secondary glaucoma.
What is the aim of treatment for Glaucoma?
----------------------------------------------------
Any damage to the optic that is discovered at diagnosis is irreversible.
The aim of treatment is thus to prevent further damage and vision loss.
This is done by lowering the intraocular pressure to a safe level.
How is Glaucoma treated?
-------------------------------
How is Glaucoma treated?
-------------------------------
1. pressure lowering eye drops
You may be prescribed eye drops to lower the intraocular pressure.
Examples are prostaglandin eye drops, which will allow better flow of fluid within the eye or beta blocker eye drops which reduces the pressure in the eye.
These has to be applied diligently in order to work well.
Examples are prostaglandin eye drops, which will allow better flow of fluid within the eye or beta blocker eye drops which reduces the pressure in the eye.
These has to be applied diligently in order to work well.
The majority of glaucoma patients can be well controlled with one or more of these eye drops
2. laser treatment
You may need laser treatment to help lower the pressure or to manage acute angle closure Glaucoma.
3. surgery
Surgery is used only:
when eye drops and/or laser treatment fails
if you develop side effects with the eyedrops
if you need other eye surgery(eg cataract)
How is Glaucoma monitored?
2. laser treatment
You may need laser treatment to help lower the pressure or to manage acute angle closure Glaucoma.
3. surgery
Surgery is used only:
when eye drops and/or laser treatment fails
if you develop side effects with the eyedrops
if you need other eye surgery(eg cataract)
How is Glaucoma monitored?
-----------------------------------
He will check whether treatment is effective by:
measuring your intraocular pressure
examining the optic nerve for further damage
analysing your visual fields.
With proper monitoring and treatment most patients will be lessat risk of blindness.
Added 4th October 2008
----------------------------------
Glaucoma
-----------------
The best painkiller for glaucoma pain is Tegretol which relieve the pain in the nerves.
Acupuncture has been used to reduce the pressure in the eye as an alternative method of treatment.
Tuesday, August 14, 2007
A Simple Guide to Chickenpox
A Simple Guide to Chickenpox
-----------------
What is Chickenpox?
------------
Chickenpox is a mild illness common among children but can occur at any age.
A fever appears followed by an itchy rash of spots that look like blisters all over the body on the second or third day and may be accompanied by flu-like symptoms.
What causes Chickenpox?
-------------------------------
Chickenpox is caused by the varicella-zoster virus.
What are the Symptoms of Chickenpox?
-----------------------------------------------
Chickenpox usually starts with a mild fever of 37.7 - 38.8 Celsus with or without headache.
It is followed by a red, itchy rash on the skin that usually appears first on the abdomen or back and face, and then spreads to almost everywhere else on the body.
The rash begins as multiple small, red bumps and rapidly develop into thin-walled blisters filled with clear fluid, which becomes cloudy. The blister wall breaks, leaving open sores, which finally crust over to become dry, brown scabs.
Chickenpox blisters can also occur in the mouth causing pain and discomfort when eating.
Some children have abdominal pain, sore throat, headache,and in some cases a severe cough.
Younger children often have milder symptoms and fewer blisters than older children or adults.
When is Chickenpox contagious?
---------------------------------------
Chickenpox is contagious from about 2 days before the rash appears and lasts until all the blisters are crusted over.
A child with chickenpox should be kept out of school until all blisters have dried, usually about 10 days.
Chickenpox is very contagious — most kids with a sibling who's been infected will get it as well, showing symptoms about 2 weeks after the first child does.
To help keep the virus from spreading, make sure your children wash their hands frequently, particularly before eating and after using the bathroom.
And keep a child with chickenpox away from unvaccinated siblings as much as possible.
Pregnant women and anyone with immune system problems should not be near a person with chickenpox. If a pregnant woman who hasn't had chickenpox in the past contracts it (especially in the first 20 weeks of pregnancy), the fetus is at risk for birth defects. If she develops chickenpox just before or after the child is born, the newborn is at risk for serious health complications.
How to avoid getting Chickenpox?
----------------------------------------
Since May 2006, after FDA approval of the vaccine, Doctors recommend that kids receive the chickenpox vaccine when they are 12 to 15 months old and a booster shot at 4 to 6 years old. The vaccine is about 70% to 85% effective at preventing mild infection, and more than 95% effective in preventing moderate to severe forms of the infection.
Healthy children who have had chickenpox do not need the vaccine — they usually have lifelong protection against the illness.
How to treat Chickenpox?
-------------------------------
Treatment of Virus:A virus causes chickenpox, so the doctor won't prescribe antibiotics. However, antibiotics may be required if the sores become infected by bacteria.
The antiviral medicine acyclovir may be prescribed for people with chickenpox who are at risk for complications. The drug, which can make the infection less severe, must be given within the first 24 hours after the rash appears.
Treatment of Symptoms:You can help relieve the itchiness, fever, and discomfort of chickenpox by:
1.Using cool wet compresses or giving baths in cool or lukewarm water every 3 to 4 hours for the first few days.
2.Patting (not rubbing) the body dry.
3.Putting calamine lotion on itchy areas or acyclovir cream lightly over the rashes
4.Giving your child foods that are soft and bland because chickenpox in the mouth may make drinking or eating difficult.
5.Make the child drink lots of fluids
6. Anti itch medicine like antihistamine or pain relieving medicine like paracetamol may be given to relieve itch or pain.
7.As much as possible, discourage scratching. This can be difficult for the child, so consider putting mittens or socks on your child's hands to prevent scratching during sleep. In addition, trim fingernails and keep them clean to help lessen the effects of scratching, including broken blisters and infection.
What are the complications of Chickenpox?
---------------------------------------------------
Typically, chickenpox is a mild illness, but can affect some infants, teens, adults, and people with weak immune systems more severely.
Some people can develop serious bacterial infections involving the skin(especially in children with eczema), lungs(pneumonia) and the brain (encephalitis).
What is the outlook for Chickenpox?
-------------------------------------------
Most children recovered completely from chickenpox within 7-14 days of the onset of symptoms.
Adults may take a longer time to recover(10-21 days) and the symptoms are more severe.
Pox marks due to infections of the skin and deep scratching of blisters may remain and serve as a reminder of chickenpox.
A person usually has only one episode of chickenpox, but the virus can lie dormant within the body and cause a different type of skin eruption later in life called shingles (or herpes zoster).
-----------------
What is Chickenpox?
------------
Chickenpox is a mild illness common among children but can occur at any age.
A fever appears followed by an itchy rash of spots that look like blisters all over the body on the second or third day and may be accompanied by flu-like symptoms.
What causes Chickenpox?
-------------------------------
Chickenpox is caused by the varicella-zoster virus.
What are the Symptoms of Chickenpox?
-----------------------------------------------
Chickenpox usually starts with a mild fever of 37.7 - 38.8 Celsus with or without headache.
It is followed by a red, itchy rash on the skin that usually appears first on the abdomen or back and face, and then spreads to almost everywhere else on the body.
The rash begins as multiple small, red bumps and rapidly develop into thin-walled blisters filled with clear fluid, which becomes cloudy. The blister wall breaks, leaving open sores, which finally crust over to become dry, brown scabs.
Chickenpox blisters can also occur in the mouth causing pain and discomfort when eating.
Some children have abdominal pain, sore throat, headache,and in some cases a severe cough.
Younger children often have milder symptoms and fewer blisters than older children or adults.
When is Chickenpox contagious?
---------------------------------------
Chickenpox is contagious from about 2 days before the rash appears and lasts until all the blisters are crusted over.
A child with chickenpox should be kept out of school until all blisters have dried, usually about 10 days.
Chickenpox is very contagious — most kids with a sibling who's been infected will get it as well, showing symptoms about 2 weeks after the first child does.
To help keep the virus from spreading, make sure your children wash their hands frequently, particularly before eating and after using the bathroom.
And keep a child with chickenpox away from unvaccinated siblings as much as possible.
Pregnant women and anyone with immune system problems should not be near a person with chickenpox. If a pregnant woman who hasn't had chickenpox in the past contracts it (especially in the first 20 weeks of pregnancy), the fetus is at risk for birth defects. If she develops chickenpox just before or after the child is born, the newborn is at risk for serious health complications.
How to avoid getting Chickenpox?
----------------------------------------
Since May 2006, after FDA approval of the vaccine, Doctors recommend that kids receive the chickenpox vaccine when they are 12 to 15 months old and a booster shot at 4 to 6 years old. The vaccine is about 70% to 85% effective at preventing mild infection, and more than 95% effective in preventing moderate to severe forms of the infection.
Healthy children who have had chickenpox do not need the vaccine — they usually have lifelong protection against the illness.
How to treat Chickenpox?
-------------------------------
Treatment of Virus:A virus causes chickenpox, so the doctor won't prescribe antibiotics. However, antibiotics may be required if the sores become infected by bacteria.
The antiviral medicine acyclovir may be prescribed for people with chickenpox who are at risk for complications. The drug, which can make the infection less severe, must be given within the first 24 hours after the rash appears.
Treatment of Symptoms:You can help relieve the itchiness, fever, and discomfort of chickenpox by:
1.Using cool wet compresses or giving baths in cool or lukewarm water every 3 to 4 hours for the first few days.
2.Patting (not rubbing) the body dry.
3.Putting calamine lotion on itchy areas or acyclovir cream lightly over the rashes
4.Giving your child foods that are soft and bland because chickenpox in the mouth may make drinking or eating difficult.
5.Make the child drink lots of fluids
6. Anti itch medicine like antihistamine or pain relieving medicine like paracetamol may be given to relieve itch or pain.
7.As much as possible, discourage scratching. This can be difficult for the child, so consider putting mittens or socks on your child's hands to prevent scratching during sleep. In addition, trim fingernails and keep them clean to help lessen the effects of scratching, including broken blisters and infection.
What are the complications of Chickenpox?
---------------------------------------------------
Typically, chickenpox is a mild illness, but can affect some infants, teens, adults, and people with weak immune systems more severely.
Some people can develop serious bacterial infections involving the skin(especially in children with eczema), lungs(pneumonia) and the brain (encephalitis).
What is the outlook for Chickenpox?
-------------------------------------------
Most children recovered completely from chickenpox within 7-14 days of the onset of symptoms.
Adults may take a longer time to recover(10-21 days) and the symptoms are more severe.
Pox marks due to infections of the skin and deep scratching of blisters may remain and serve as a reminder of chickenpox.
A person usually has only one episode of chickenpox, but the virus can lie dormant within the body and cause a different type of skin eruption later in life called shingles (or herpes zoster).
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