A Simple Guide to Tonsillitis

A Simple Guide to Tonsillitis
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What is Tonsillitis?
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Tonsillitis is inflammation (swelling) of the tonsils.
The tonsils are lymph nodes in the back of the mouth and top of the throat.
They normally help to filter out bacteria and other germs to prevent infection in the body.
They may become so overwhelmed by bacterial or viral infection that they swell and become inflamed, causing tonsillitis.
The infection may also be present in the throat and surrounding areas, causing pharyngitis. The inflammation may involve other areas of the back of the throat including the adenoids and the lingual tonsils (areas of tonsil tissue at the back of the tongue).

What causes Tonsillitis?
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Viral or bacterial infections and low immunity lead to tonsillitis and its complications.
Viral:
The herpes simplex virus, Epstein-Barr virus (EBV), cytomegalovirus, adenovirus, and the measles virus cause most cases of acute pharyngitis and acute tonsillitis.
Bacteria:
Bacteria cause 15-30 percent of pharyngotonsillitis cases.
Streptococcus pyogenes is the most common bacteria causing acute Tonsillitis

Who gets tonsillitis?
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Tonsillitis most often occurs in children but rarely in children younger than 2 years.
Tonsillitis caused by Streptococcus species typically occurs in children aged 5-15 years.
Viral tonsillitis is more common in younger children.
A peritonsillar abscess is usually found in young adults but occur occasionally in children.

What are types of Tonsillitis?
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There are several variations of tonsillitis:
1.acute
2.recurrent
3.chronic tonsillitis and
4.peritonsillar abscess.

What are the symptoms of tonsillitis?
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The type of tonsillitis determines what symptoms will occur.

Acute tonsillitis:
Patients have a
Ear pain
Fever, chills
Headache
Sore throat - severe, lasts longer than 48 hours
Tenderness of the jaw and throat
Voice changes, loss of voice
Foul breath
dysphagia (difficulty swallowing)
Odynophagia (painful swallowing) and
tender cervical lymph nodes.

Airway obstruction due to swollen tonsils may cause mouth breathing, snoring, nocturnal breathing pauses, or sleep apnea.
Lethargy and malaise are common.

These symptoms usually resolve in three to four days but may last up to two weeks despite therapy.

Recurrent tonsillitis:
This diagnosis is made when an individual has multiple episodes of acute tonsillitis in a year.

Chronic tonsillitis:
Individuals often have
Chronic sore throat,
Foul breath,
Enlarged tonsils, and
Persistently tender cervical nodes.

Peritonsillar abscess:
Individuals often have
Severe throat pain,
fever, Drooling,
Foul breath,
Trismus (difficulty opening the mouth), and
Muffled voice quality (as if talking with a hot potato in his or her mouth).

What are the signs of Tonsillitis?
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The health care provider will look in the mouth and throat for signs of:

1.enlarged, visible tonsils that are usually reddened with white spots (pus) on them.

2.enlarged and tender lymph nodes of the jaw and neck.

3.Fever and chills.

4.Open-mouth breathing and muffled voice resulting from obstructive enlarged tonsils.

5.neck and jaw stiffness (often found in acute tonsillitis).

6.Signs of dehydration (found by examination of skin and mucosa).

7.Palatal petechiae (pinpoint bleeding spots on the soft palate).

8.Unilateral bulging above and to the side of one of the tonsils in peritonsillar abscess .

A culture of the tonsils may show bacterial infection.
A culture for the streptococcus bacteria (strep) may be taken using a throat swab because it is the most common and most dangerous form of tonsillitis.

What is the treatment of Tonsillitis?
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1.If the cause of the tonsillitis is bacteria such as strep, antibiotics are given to cure the infection.
The antibiotics may need to be taken for 10 days by mouth.
They must not be stopped just because the discomfort stops, or the infection will NOT be cured.Some health care providers will treat all tonsillitis with antibiotics to prevent the chance of strep-related complications.

2.Rest to allow the body to heal.

3. Fluids especially warm (not hot), bland fluids or very cold fluids may soothe the throat. Gargle with warm salt water or suck on lozenges (containing benzocaine or similar ingredients) to reduce pain.Fluid replacement and pain control are important.

4.Hospitalization may be required in severe cases and when there is airway obstruction.

5. When the condition is chronic or recurrent, a surgical procedure to remove the tonsils (tonsillectomy) is often recommended.

What is the Prognosis of Tonsillitis?
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Tonsillitis symptoms usually lessen in 2 or 3 days after treatment starts.
The infection usually is cured by then, but may require more than one course of antibiotics.
A tonsillectomy may be recommended if tonsillitis is severe, recurrent, or does not respond to antibiotics.

What are the Complications of Tonsillitis?
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1.Complications of untreated strep tonsillitis may be severe:
Rheumatic fever and subsequent cardiovascular disorders
Post-streptococcal glomerulonephritis followed by kidney failure

2.Dehydration from difficulty swallowing fluids

3.Blocked airway from enlarged tonsils

4.Peritonsillar abscess or abscess in other parts of the throat

A Simple Guide to Sinusitis

A Simple Guide to Sinusitis
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What is sinusitis?
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Sinusitis is a condition in which the lining of your sinuses becomes inflamed.

The sinuses are the air chambers in the bone behind your cheeks, eyebrows and jaw.
They produce mucus, a fluid that cleans bacteria and other particles out of the air you breathe. Tiny hairs called cilia sweep mucus out of your sinuses so it can drain out through your nose.
The paranasal sinuses are in direct communication with the nose.
The sinuses are normally sterile.

If the sinus openings may become blocked, the mucus becomes congested in the sinuses, resulting in stagnation of secretion and finally bacterial growth.

What causes sinusitis?
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Anything that causes swelling in your sinuses or keeps the cilia from moving mucus can cause sinusitis.
This can occur because of changes in temperature or air pressure,
Using decongestant nasal sprays too much,
Smoking, and
Swimming or diving.
Some people have growths called polyps that block their sinus passages.
When sinusitis is caused by a bacterial or viral infection, you get a sinus infection.

Sinus infections sometimes occur after you've had a cold.
The cold virus attacks the lining of your sinuses, causing them to swell and become narrow.
Your body responds to the virus by producing more mucus, but it gets blocked in your swollen sinuses.
This built-up mucus makes a good place for bacteria to grow.
The bacteria can cause a sinus infection.

Acute sinusitis is usually bacterial in origin.
Haemophilus influenzae and Streptococcus pneumoniae are the organisms most commonly found in adults.
In children, similar organisms are seen, with the addition of Moraxella catarrhalis.
In older children and young adults, Staphylococcus aureus is an occasional finding.
In systemically impaired hosts, Candida, Aspergillus, and Phycomycetes may be the cause.

Risk factors include the following: diabetes mellitus, cancer, hepatic disease, renal failure, burns, extreme malnutrition, and immunosuppressive diseases.

What are the signs of acute sinusitis?
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Presentation of sinusitis is often nonspecific.

Patients may present with a persistent cold.
A cold that starts to get better and then gets worse may be a sign of acute sinusitis.

Pain or pressure in some areas of the face (forehead, cheeks or between the eyes) is often a sign of blocked sinus drainage and can be a sign of acute sinusitis.

Pain in your forehead that starts when you lean forward can also be a sign.

Other symptoms may include a stuffy nose.

Some patients complain of dental pain or alteration in smell.

Fever is seen in fewer than 2% of individuals with sinusitis.

Facial tenderness to palpation is present.

Complete opacification of sinus on transillumination is present.

An X-ray of the paranasal sinuses usually confirms the presence of sinusitis as opacity in the sinuses.

How is acute sinusitis treated?
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Your doctor may prescribe an antibiotic.
You may take an antibiotic for 10 to 14 days, but you will usually start feeling better a couple of days after you start taking it. It is important to take this medicine exactly as your doctor tells you and to continue taking it until it is gone, even after you're feeling better.

If you have sinus pain or pressure, your doctor may prescribe or recommend a decongestant to help your sinuses drain.

Painkillers may be prescribed if there is severe pain.

How to take care of sinusitis?
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1.Get plenty of rest.

2.Lying down can make your sinuses feel more congested, so try lying on the side that lets you breathe the best.

3.Drink plenty of fluids.

4.Apply moist heat by holding a warm, wet towel against your face or breathing in steam through a cloth or towel.

5.Rinse your sinus passages with a saline solution.

How is chronic sinusitis treated?
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In cases where the acute sinus infection does not cleared or become chronic, a sinus washout may be necessary to remove the mucus stucked in the sinuses.

This involves syringing of antiseptic solution through a hole in the septum separating the maxillary sinuses from the nose.
Sometimes syringing of frontal sinuses can be done through a tube inserted into the sinuses.

In severe case of chronic sinusitis, endoscopy surgery may be done to strip the lining of the maxillary sinuses and clean the cavity of the sinuses.

A new therapy is the use of phage therapy where bacterial viruses are used to cause bacterila lysis in the sinuses.

A Simple Guide to Conjunctivitis

A Simple Guide to Conjunctivitis
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What is Conjunctivitis?
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Conjunctivitis is an inflammation of the conjunctiva(the white of the eye and inner lining of eyelids).
It is one of the most common and treatable eye infections in children and adults.

What causes Conjunctivitis?
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Conjunctivitis can be caused by a
virus
bacteria
irritating substances (shampoos, dirt, smoke, and especially pool chlorine)
allergens (substances that cause allergies).

Conjunctivitis caused by bacteria, viruses can spread easily from person to person, but is not a serious health risk if diagnosed promptly.

What are the symptoms of Conjunctivitis?
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1.Redness in the white of the eye or inner eyelid

2.tears overflowing

3.yellow discharge that crusts over the eyelashes, especially after sleep
Other discharge from your eye (green or white) .

4.Pain in the eye

5.Itchy eyes (especially in conjunctivitis caused by allergies)

6.Burning eyes (especially in conjunctivitis caused by chemicals and irritants)

7.Blurred vision

8.sensitivity to light

How is Conjunctivitis spread?
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Bacterial or viral Conjunctivitis can also be spread through hand contact when rubbing the eyes or touching contact lenses after touching infected skin.

Being around a person who has conjunctivitis and wearing contact lenses may increase your risk of getting conjunctivitis, but the outcome is usually very good with treatment.

How is Conjunctivitis treated?
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Bacteria:Conjunctivitis caused by bacteria is treated with antibiotics.
The antibiotic can be given as eye drops, ointments, or pills.
Eye drops or ointments may need to be applied to the inside of the eyelid three to four times a day for five to seven days.

Virus: No Medicine can treat conjunctivitis caused by a virus.
This type of conjunctivitis often results from a common cold.
You may, however, help relieve symptoms by applying a cold compress.

Irritating substance:For this type of conjunctivitis, use warm water for five minutes to wash the irritating substance from the eye.

Allergies:Allergy-associated conjunctivitis is treated with antihistamines or when the allergen is determined and removed.

How to relieve symptoms of Conjunctivitis?
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1.Protect your eyes from dirt and other irritating substances.

2.Do not use contact lenses, if you wear them.

3.Place cold compresses on your eyes.

4.Wash your face and eyelids with mild soap or baby shampoo and rinse with water to remove irritating substances.

5.Do not rub your eyes with hands that are not washed.

6. Do not use the same bottle of drops in the other eye if it is not infected.

How to prevent spreading Conjunctivitis?
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1.Do not touch or rub the infected eye(s).

2.Wash your hands often with soap and warm water.

3.Wash any discharge from your eyes twice a day using a fresh cotton ball or paper towel. Afterwards, discard the cotton ball and wash your hands with soap and warm water.

4.Wash your bed linens, pillowcases, and towels in hot water and detergent.

5.Avoid wearing eye makeup.
Don’t share eye makeup with anyone else.

6.Do not wear another person’s contact lens.

7.Wear glasses instead of contact lenses.
Throw away disposable lenses or be sure to clean extended wear lenses and all eyewear cases.

8.Avoid sharing common articles such as unwashed towels, cups, and glasses.

9.Wash your hands after applying the eye drops or ointment to your eye or your child’s eye.

10.Do not use eye drops in a non-infected eye that were used for an infected one.

A Simple Guide to Shingles

A Simple Guide to Shingles
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What is Shingles?
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Shingles or Herpes zoster is a condition where a crop of blisters caused by the varicella zoster virus form a band across one side of the chest, abdomen or face.

What is the cause of shingles?
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The same virus that causes chicken pox causes shingles.
The chickenpox virus remains in a dormant state in certain nerve cells of the body from months to many years, and then reactivates, causing shingles.

This infection is due to a temporary decrease in the body's resistance, allowing the virus to start multiplying and to move along nerve fibres towards the skin.

Who are the People at risk of getting Shingles?
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About 1 in 10 people who had chickenpox as children will develop shingles as adults.
The disease occurs
1.more often in older people (over 50 years old) because the immune response is believed to be weaker in older people.

2.Trauma or possibly stress may also contribute to an attack of shingles.

3.Weakened Immune system people like those with cancer, eg. Leukaemia, lymphoma, undergoing chemotherapy or radiation therapy for cancer, patients with organ transplants and taking drugs to ward off transplant rejection and patients with diseases that lowers the immune system eg. AIDS.

What are the symptoms of shingles?
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The first symptom is a burning pain or tingling and extreme sensitivity in one area of the skin.
This may be present for one to three days before a red rash occurs.
A group of blisters then forms on a red base which looks like chicken pox lesions.
The blisters generally last for two to three weeks, during which time they accumulate pus and then crust over and begin to disappear.

The pain may last longer for a month or longer.
A slight discoloration or scarring of the skin is also possible.

How severe is the pain of Shingles?
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The pain is usually severe enough for the doctor to prescribe painkillers.
A long-lasting painful complication of shingles called post-herpetic neuralgia occurs in some older patients.
This may last long after the shingles have healed.
For these people the slightest touch or contact with clothing can be unbearable.

Where do shingles appear on the body?
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Shingles generally affect only one side of the body.

Most commonly, blisters will appear on the chest or abdomen, including the buttocks and genitalia, and even the face.

If the blisters involve the eye region, permanent eye damage can result.
Your doctor will refer you immediately to an eye specialist when such a complication develops.

What are the complications of Shingles?
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Post-herpetic neuralgia, a condition in which either constant or episodic pain persists for a long time after the skin has healed.
About 50% of affected patients are over the age of 60 years.
The chronic pain is believed to be due the damage to nerve endings.

People who suffer this long-term pain may experience psychological suffering such as depression, insomnia and weight loss.

Infection of the blisters by bacteria can also cause delayed healing of the skin.
Antibiotic treatment is needed.

If the shingles affects the forehead, sometimes inflammation of ophthalmic nerve of the eye may occur. It may cause severe pain in the eye and cause blindness. Damage to the cornea may also occur.

If the shingles affect the the ear, it may cause pain, tinnitus (buzzing sound in the ear), dizziness, loss of hearing or an increased risk of spread to the brain.

In patients with weakened immune systems, there may be high fever and spread of the disease all over the body.

Is shingles contagious?
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Shingles is much less contagious than chicken pox.
People with shingles can spread the virus if blisters are broken to someone who has never had chicken pox or who is already ill.

The people who are at risk include babies and those who already are ill such as cancer patients.
These people will develop chickenpox.

How severe is the pain of Shingles?
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The pain is usually severe enough for the doctor to prescribe painkillers.
A long-lasting painful complication of shingles called post-herpetic neuralgia occurs in some older patients. This may last long after the shingles have healed.
For these people the slightest touch or contact with clothing can be unbearable.

Does Shingles cause much scarring?
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Shingles can result in scarring if the blisters are infected or if the patients have used toxic home remedies on the blisters.

Some Chinese physicians believe that a snake in the skin causes the disease and the head of the snake must be burned with chemicals in order to stop the snake from growing.

How is shingles treated?
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In most cases Shingles clears on its own in a few weeks and seldom recurs.

Treatment consists of painkillers, as well as cool compresses to help dry the blisters.

Antibiotics are given if there is bacterial infection.

The antiviral drug, acyclovir, may be given especially for patients with eye involvement or who are very ill.
It is useful only if it is started early in the disease.
The earlier it is taken after the disease begins the better the effect.
The drug might prevent post-herpetic neuralgia.
Post-herpetic neuralgia can be treated with painkillers and high doses of tranquilisers at night.

A Simple guide to Hemorrhoids

A Simple guide to Hemorrhoids
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What are hemorrhoids?
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Hemorrhoids or piles are distended veins inside the anus which are swollen and inflamed. Hemorrhoids are either inside the anus (internal) or under the skin around the anus (external).

What is the cause of hemorrhoids?
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Hemorrhoids usually result from straining to pass the stool out of anus. Other contributing factors include pregnancy, aging, chronic constipation or diarrhea.

What are the symptoms of hemorrhoids?
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The most common symptom of internal hemorrhoids is bleeding from the anus.Bright red blood may be seen covering the stool, on toilet paper, or dripping from the anus into the toilet bowl.
There may be pain too especially if the stool is hard. This could be due to the hard stools pressing on the swollen piles or due to a tear in the inner lining of the anus.

A painful swelling or a hard lump around the anus may occur when a blood clot forms. This condition is known as a thrombosed hemorrhoid.

In addition, excessive straining, rubbing, or cleaning around the anus may cause irritation with bleeding and/or itching.

How common are hemorrhoids?
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Hemorrhoids are very common in both men and women. About half of the population have hemorrhoids by age 50.
Hemorrhoids are also common among pregnant women. The pressure of the fetus in the abdomen, as well as hormonal changes, cause the hemorrhoidal vessels to enlarge. For most women, however, hemorrhoids caused by pregnancy are temporary.

When are hemorrhoids diagnosed?
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A thorough examination and proper diagnosis by the doctor is important any time bleeding from the rectum or blood in the stool occurs. Bleeding may also be a symptom of other digestive diseases, including colorectal cancer.

The doctor will examine the anus and rectum to look for swollen blood vessels that indicate hemorrhoids and will also perform a digital rectal exam with a gloved, lubricated finger to feel for abnormalities.

Closer evaluation of the rectum for hemorrhoids requires an exam with a proctoscope, useful for more completely examining the entire rectum.

To rule out other causes of gastrointestinal bleeding, the doctor may examine the rectum and the entire colon with colonoscopy.
Colonoscopy is a diagnostic procedure that also involve the use of lighted, flexible tube inserted through the rectum.

What is the treatment?
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a.Medical treatment of hemorrhoids is aimed initially at relieving symptoms. Measures to reduce symptoms include:

1.tub baths several times a day in plain, warm water for about 10 minutes
2.application of a hemorroidal cream or suppository to the affected area.
3. medicines such as daflon to shrink the swollen blood vessel.

b. Surgical treatment:A number of methods may be used to remove or reduce the size of internal hemorrhoids.
These techniques include
1.Rubber band ligation. A rubber band is placed around the base of the hemorrhoid inside the rectum. The band cuts off circulation, and the hemorrhoid withers away within a few days.
2.Sclerotherapy. A chemical solution is injected around the blood vessel to shrink the hemorrhoid.
3.Laser coagulation. A special device is used to burn hemorrhoidal tissue.
4.Hemorrhoidectomy. Occasionally, extensive or severe internal or external hemorrhoids may require removal by surgery known as hemorrhoidectomy.
5.A new method is the Longo technique. It involve using a circular stapling device which removes a ring of tissue in the lower anus pulling the enlarged piles up within the anus. The staples also interrupt the blood supply to the piles

How do you prevent hemorrhoids?
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The best way to prevent hemorrhoids is to keep stools soft so they pass easily, thus decreasing pressure and straining, and to empty bowels as soon as possible after the urge occurs.

Drink lots of water at least eight glasses a day.

Eating the right amount of fiber result in softer, bulkier stools. A softer stool makes emptying the bowels easier and lessens the pressure on hemorrhoids caused by straining. Good sources of fiber are fruits, vegetables, bran bread, and whole grains.

Avoid food which cause local irritation of anus (spicy food,alcohol) or bowel excitation (coffee,tea)

Exercise, including walking, swimming, help reduce constipation and straining by producing stools that are softer and easier to pass.
Avoid certain sports such as cycling and horse -riding because of the pressure exerted on the anal region.

Avoid sitting in hot places for too long.

Use the toilet at a fixed time eg. after drinking a big glass of water, when you wake up.