A Simple Guide to Adenoiditis

A Simple Guide to Adenoiditis
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What is Adenoiditis?
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Adenoiditis is inflammation (swelling) of the Adenoids.

The adenoids are lymph nodes in the back of the nose and above the throat.

They normally help to filter out bacteria and other microorganisms to prevent infection in the nose and throat area.

They may become so overwhelmed by bacterial or viral infection that they swell and become inflamed, causing Adenoiditis.

Enlarged adenoids can cause blockage of the eustachian tubes and posterior openings of the nose.

What causes Adenoiditis?
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1.Viral or bacterial infections
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Bacteria cause 15-30 percent of Adenoiditis cases.
Streptococcus pyogenes is the most common bacteria causing acute Adenoiditis.

The herpes simplex virus, Epstein-Barr virus (EBV), cytomegalovirus, adenovirus, and the measles virus cause most cases of acute Adenoiditis.


2.low immunity factors
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Unbalanced or insufficient food diet,

Unhygienic lifestyle

Inadequate rest or sleep

3. Allergy
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dustmites,

pollens

Who gets Adenoiditis?
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Adenoiditis most often occurs in children but rarely occurs in children younger than two years.

It is occasionally found in young adults.

What are the symptoms of Adenoiditis?
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The Symptoms of Adenoiditis are:

1,Blocked nose

2.mouth breathing

3.nasal speech

4.rhinorhoea(runny nose)

5.Snoring at night

6.Ear blockage(eustachian tube blockage)

7.Ear pain(otitis media)

8.Pain in the cheeks(maxillary sinusitis) or above the eye(frontal sinusitis)

9.Headache

10.Fever, chills

11.Lethargy and malaise are common.

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

What are the signs of Adenoiditis?
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An ear nose and throat specialist will be able to put a endoscope through the nasal passage to see the enlarged and inflamed adenoids.

What are the Complications of Adenoiditis?
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1.Complications of untreated streptococcus Adenoiditis with tonsillitis may be severe:

Rheumatic fever and subsequent cardiovascular disorders
Post-streptococcal glomerulonephritis followed by kidney failure

2.Ear pain from otitis media

3.Blocked airway from enlarged Adenoids

What is the treatment of Adenoiditis?
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1.If the cause of the Adenoiditis is bacteria such as streptococcus, 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.

2.Rest to allow the body to heal.

3. Fluids especially warm (not hot), bland fluids or very cold fluids may soothe the nose and throat.

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

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

What is the Prognosis of Adenoiditis?
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Adenoiditis 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.

Adenoidectomy may be recommended if Adenoiditis is severe, recurrent, or does not respond to antibiotics.

A Simple Guide to Amenorrhea

A Simple Guide to Amenorrhea
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What is Amenorrhea?
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Amenorrhea is a symptom defined as absence of menstruation.

What are the types of Amenorrhea?
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1.Primary Amenorrhea
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is defined as the absence of onset of menstruation (menarche) in a girl who has reached the age of 18 years.

2.Secondary Amenorrhea
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is defined as the absence of menstruation for a peroid of at least 6 months in a girl who has previously experienced normal menstruation and is not pregnant.

What are the causes of Amenorrhea?
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1.Physiological(hormonal):
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pregnancy hormones - pregnancy is the still the most common cause of secondary amenorrhea.
Growth hormone deficiency
Abnormal production of testosterone

2.Genetic Causes:
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abnormal formation of genital tract causing cryptomenorrhea -obstruction to the flow of menstrual blood such as imperforate hymen
Chromosonal abnormalities:
Turner syndrome
Ovarian agenesis

3.Uterine Pathology:
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adhesions from previous operation
endometriosis
tuberculosis infection
radiation

4.Ovarian:
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Agenesis(no ovaries)
Abnormal ovaries(again congenital)
Polycystic Ovaries
Granulosa-thca tumours of ovaries
radiation of ovaries

5.Pituitary:
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Pituitary tumours
Hypopituitarism
Hypothalamic abnormalities

6.Psychological:
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Depression
Anorexia nervosa,
starvation

7.Systemic Diseases:
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Hypothyoidism
Cushing syndrome

8.Medical causes:
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Chemotherapy
oral cotraceptive
corticosteroids
hypotensive drugs

How to establish a diagnosis of Amenorrhea
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History:
1.Primary Amenorrhea
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Genetic disorders:
failure to develop female sex characteristics
anatomic abnormalities due to chromosonal defects such as Turner syndrome
hirsutism-excessive male hormones

2.Secondary Amenorrhea
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Metabolic disorders:
symptoms of hypothyroidism
symptoms of polycystic ovarian syndrome
Obesity

Pyschologic disorders:
depression
anorexia nervosa

Pelvic examination:
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vulval and vaginal examination for cryptomenorrhea,
bimanual palpation for ovarian masses like polystic ovaries
abnormal uterus or ovaries

Investigations:
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Pregnancy test

blood for follicle stimulating hormones, luteinising hormones, prolactin

Progesterone withdrawal bleeding test
Luteinizing hormone releasing tests

Serum testesterone and androsterones

Transvaginal ultrasound to check on the uterus and ovaries
X-ray Skull, Brain CAT or MRI scans to exclude pituitary tumours

What is the Treatment of Amenorrhea?
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Medications:
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Specific treatment for amenorrhea depends on:

1.age,
2.overall health,
3.cause of the condition (primary or secondary)
4.the preference of the patient

Treatment for amenorrhea may include:
1.Pregnancy - no treatment if the patient wish to continue with pregnancy. Usually a referral to an obstetrician may be necessary

2.hormonal replacement(oestrogen and progesterone supplements ) in genetic cases and androgen producing tumours.

3.Cyproterone acetate is an anti-androgen which counters the effects of male hormones. It is usually given with a small dose of oestrogen.

4.Hyperprolactinaemia -treatment with bromocriptine which acts by stimulating the prolactin Inhibiting factor in the hypothalamus.

5.Polycystic ovary Disease -clomiphene and gonadatrophins may be given to improve menstruation and help fertility

6.Adrenal dysfunction due to deficiency of the enzyme 21-hydroxylase (androgegenital syndrome) results in excess ACTH and excessive production of androgens-treatment is with corticosteroids such as prednisolone

Other Treatments:
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1.Treatment of underlying systemic disease like thyroxine for hypothyroidism,

2.dietary changes to include increased caloric and fat intake especially in cases of low fat due to self induced dieting, anorexia nervosa

3.Pyschiatric treatment for women with depression, anorexia nervosa, or genetic dysfunction.

4.Healthy lifestyle for those who are obese