A Simple Guide to Syphilis
--------------------------------
What is Syphilis?
----------------------
Syphilis is a infectious sexually transmitted disease caused by the bacterium Treponema pallidum.
It can be acute, subacute or chronic depending on the stage.
How is Syphilis spread?
----------------------------
Syphilis is passed from a infected person through sexual contact with a infected sore which occur mainly on the external genitals, anus, or rectum.
The lips and the mouth may also have sores.
The bacteria can penetrate through normal mucous membrane and minor abrasions of the epithelium.
Transmission of the organism usually occurs during sexual contact.
Pregnant women with the disease can pass it to the babies they are carrying.
What are the symptoms of Syphilis?
--------------------------------------------
The signs and symptoms of syphilis may occur in four stages:
Primary
----------
These signs may occur from 10 to 90 days after exposure:
1.A small, firm, painless sore (chancre) appears on the body where the syphilis enter the body, usually the genitals, rectum, or lips.
A single chancre is typical, but there may be multiple sores.
2.Enlarged lymph nodes in your groin.
The chancre lasts 3 to 6 weeks, and it heals without treatment.
However, if untreated, the infection progresses to the secondary stage.
Secondary
----------
The signs and symptoms of secondary syphilis may begin two to 10 weeks after the chancre appears, and may include:
1.Rash marked by red or reddish-brown sores over any area of the body especially the palms and soles. The rash usually does not cause itching.
2.Fever
3.Fatigue and a vague feeling of discomfort
4.swollen lymph glands,
5.sore throat,
6.weight loss,
7.Soreness and aching
The signs and symptoms of secondary syphilis will resolve with or without treatment.
Without treatment, the infection will progress to the latent and late stages of disease.
Latent
--------
A period called latent syphilis in which no symptoms are present may follow the secondary stage.
Signs and symptoms may not appear until the disease may progress to the tertiary stage.
Tertiary
----------
Without treatment, syphilis bacteria may spread, leading to serious internal organ damage including the brain, nerves, eyes, heart, blood vessels, liver, bones,joints and finally death years after the original infection.
1.Neurological problems. These may include stroke; infection and inflammation of the membranes and fluid surrounding the brain and spinal cord (meningitis); poor muscle coordination; numbness; paralysis; deafness or visual problems; personality changes; and dementia.
2.Cardiovascular problems. These may include bulging (aneurysm) and inflammation of the aorta and of other blood vessels.
Syphilis may also cause valvular heart disease, such as aortic valve insufficiency.
Many people infected with syphilis do not have any symptoms for years, yet remain at risk for late complications if they are not treated.
What is the danger of Syphilis during pregnancy?
----------------------------------------------------------
The syphilis bacterium can infect the baby of a woman during her pregnancy. Depending on how long a pregnant woman has been infected, she may have a high risk of having a stillbirth or of giving birth to a baby who dies shortly after birth.
An infected baby may be born without signs or symptoms of disease.
Untreated babies may become developmentally delayed, have seizures, or die.
How do you diagnose Syphilis?
---------------------------------------
1. dark-field microscope: examining material from a chancre using this microscope.
If syphilis bacteria are present in the sore, they will show up when observed through the microscope.
2.A blood test for syphilis antibodies is accurate, safe, and inexpensive. There will be some antibodies in the blood for months even when the disease has been successfully treated.
Because untreated syphilis in a pregnant woman can infect and possibly kill her developing baby, every pregnant woman should have a blood test for syphilis.
What is the treatment of Syphilis?
-----------------------------------------
Syphilis is easy to cure in its early stages.
Treatment with intramuscular injection of penicillin can kill the organism that causes syphilis.
If you're allergic to penicillin, other antibiotics such as erythromycin will kill the syphilis bacterium.
Treatment however will not repair damage already done.
Left untreated, the disease can lead to serious complications or death.
Persons who receive syphilis treatment must abstain from sexual contact with new partners until the syphilis sores are completely healed.
Persons with syphilis must notify their sex partners so that they also can be tested and receive treatment if necessary.
Even if you were treated for syphilis during your pregnancy, your newborn child should receive antibiotic treatment.
To make sure you're responding to the usual dosage of penicillin, the doctor likely will want you to have periodic blood tests.
Blood test may remain positive up to 18 months even after successful treatment of syphilis.
Having syphilis once does not protect a person from getting it again. Following successful treatment, people can still be susceptible to re-infection.
How do you prevent Syphilis?
---------------------------
The surest way to avoid transmission of sexually transmitted diseases, including syphilis, is to 1.abstain from sexual contact
2.in a long-term mutually monogamous relationship with a partner who has been tested and is known to be uninfected.
3.Avoiding alcohol and drug use may also help prevent transmission of syphilis because these activities may lead to risky sexual behavior.
4.Correct and consistent use of latex condoms can reduce the risk of syphilis only when the infected area or site of potential exposure is protected.
5.Complications from syphilis such as neurosyphilis are rare because of better diagnosis and treatment
Sunday, November 18, 2007
A Simple Guide to Candidiasis
A Simple Guide to Candidiasis
------------------------------------
What is Candidiasis ?
-------------------------
Candidiasis is caused usually by the fungus Candida albicans.
Other Candida species or yeasts are also responsible.
What are the causes of Candidiasis ?
-------------------------------------------
1. Broad spectrum Antibiotic therapy kills off normal bacterial flora, resulting in invasion of fungi or yeasts
2. Diabetes mellitus - the high sugar content in the blood and vagina lining are conducive to fungal or yeast infection
3. Steroid or immunosuppressive drugs suppress the immune response to bacterial and fungal infection.
What is the symptoms of Candidiasis ?
----------------------------------------------
30% of patients do not have any symptoms.
The rest have symptoms like:
1. pruritus,
2.vaginal soreness,
3.dyspareunia,
4.external dysuria, and
5.abnormal white transparent vaginal discharge with heavy odour.
About 75% of women will have at least one episode of Candidiasis, and 45% may have two or more episodes.
How do you diagnose Candidiasis ?
------------------------------------------
A diagnosis of Candida vaginitis is made clinically by the presence of:
1.external dysuria
2.vulvar pruritis, pain, swelling, and redness.
3. vulvar edema, fissures, excoriations,
4.thick curdy vaginal discharge.
The diagnosis is confirmed by
1) a Gram stain of vaginal discharge showing the presence of yeasts
2) a vaginal swab for culture shows the presence of a yeast species.
What is the treatment of Candidiasis ?
---------------------------------------------
Short-course intravaginal antifungal pessaries effectively treat uncomplicated Candidiasis .
The topically applied imidazole drugs are more effective than nystatin.
90% of patients are usually cured.
Oral Agent such as Fluconazole 150 mg may be given in one tablet in single dose.
Patients should be instructed to return for follow-up visits only if symptoms persist.
Candidiasis is not usually acquired through sexual intercourse.
A minority of male sex partners might have balanitis, which is characterized by itchy red areas on the glans of the penis.
These men benefit from treatment with topical antifungal agents to relieve symptoms.
Topical agents usually do cause any systemic side effects although in some people local burning or irritation might occur.
Oral agents sometimes cause nausea, abdominal pain, and headache.
Some abnormal elevations of liver enzymes may occur with treatment with the oral azoles.
What are the complications of Candidiasis?
---------------------------------------------------
1.Recurring Candidiasis:A small percentage of women (<5%)>.
The majority of women with recurring Candidiasis have no apparent predisposing or underlying conditions.
Vaginal cultures should be obtained from these patients to confirm the clinical diagnosis and to identify unusual species, including nonalbicans species, particularly Candida glabrata
Conventional antimycotic therapies are not as effective against these species as against C. albicans.
A longer duration of initial therapy is necessary to attempt mycologic remission before initiating a maintenance antifungal regimen:
Oral fluconazole (i.e., 100-mg, 150-mg, or 200-mg dose) weekly for 6 months
topical clotrimazole 200 mg twice a week,
clotrimazole (500-mg dose vaginal pessaries once weekly)
2.Women with underlying debilitating medical conditions (e.g., uncontrolled diabetes or on corticosteroid treatment) do not respond as well to short-term therapies.
The underlying diseases should be treated and more prolonged (i.e., 7–14 days) conventional antimycotic treatment is necessary.
3.During pregnancy, Candidiasis is quite common.
Only topical azole therapies, applied for 7 days, are recommended for use .
Oral treatment is contraindicated because of risks of deformity in the foetus.
------------------------------------
What is Candidiasis ?
-------------------------
Candidiasis is caused usually by the fungus Candida albicans.
Other Candida species or yeasts are also responsible.
What are the causes of Candidiasis ?
-------------------------------------------
1. Broad spectrum Antibiotic therapy kills off normal bacterial flora, resulting in invasion of fungi or yeasts
2. Diabetes mellitus - the high sugar content in the blood and vagina lining are conducive to fungal or yeast infection
3. Steroid or immunosuppressive drugs suppress the immune response to bacterial and fungal infection.
What is the symptoms of Candidiasis ?
----------------------------------------------
30% of patients do not have any symptoms.
The rest have symptoms like:
1. pruritus,
2.vaginal soreness,
3.dyspareunia,
4.external dysuria, and
5.abnormal white transparent vaginal discharge with heavy odour.
About 75% of women will have at least one episode of Candidiasis, and 45% may have two or more episodes.
How do you diagnose Candidiasis ?
------------------------------------------
A diagnosis of Candida vaginitis is made clinically by the presence of:
1.external dysuria
2.vulvar pruritis, pain, swelling, and redness.
3. vulvar edema, fissures, excoriations,
4.thick curdy vaginal discharge.
The diagnosis is confirmed by
1) a Gram stain of vaginal discharge showing the presence of yeasts
2) a vaginal swab for culture shows the presence of a yeast species.
What is the treatment of Candidiasis ?
---------------------------------------------
Short-course intravaginal antifungal pessaries effectively treat uncomplicated Candidiasis .
The topically applied imidazole drugs are more effective than nystatin.
90% of patients are usually cured.
Oral Agent such as Fluconazole 150 mg may be given in one tablet in single dose.
Patients should be instructed to return for follow-up visits only if symptoms persist.
Candidiasis is not usually acquired through sexual intercourse.
A minority of male sex partners might have balanitis, which is characterized by itchy red areas on the glans of the penis.
These men benefit from treatment with topical antifungal agents to relieve symptoms.
Topical agents usually do cause any systemic side effects although in some people local burning or irritation might occur.
Oral agents sometimes cause nausea, abdominal pain, and headache.
Some abnormal elevations of liver enzymes may occur with treatment with the oral azoles.
What are the complications of Candidiasis?
---------------------------------------------------
1.Recurring Candidiasis:A small percentage of women (<5%)>.
The majority of women with recurring Candidiasis have no apparent predisposing or underlying conditions.
Vaginal cultures should be obtained from these patients to confirm the clinical diagnosis and to identify unusual species, including nonalbicans species, particularly Candida glabrata
Conventional antimycotic therapies are not as effective against these species as against C. albicans.
A longer duration of initial therapy is necessary to attempt mycologic remission before initiating a maintenance antifungal regimen:
Oral fluconazole (i.e., 100-mg, 150-mg, or 200-mg dose) weekly for 6 months
topical clotrimazole 200 mg twice a week,
clotrimazole (500-mg dose vaginal pessaries once weekly)
2.Women with underlying debilitating medical conditions (e.g., uncontrolled diabetes or on corticosteroid treatment) do not respond as well to short-term therapies.
The underlying diseases should be treated and more prolonged (i.e., 7–14 days) conventional antimycotic treatment is necessary.
3.During pregnancy, Candidiasis is quite common.
Only topical azole therapies, applied for 7 days, are recommended for use .
Oral treatment is contraindicated because of risks of deformity in the foetus.
Friday, November 16, 2007
A Simple Guide to Myasthenia Gravis
A Simple Guide to Myasthenia Gravis
--------------------------------------------
What is myasthenia gravis?
----------------------------------
Myasthenia gravis is a rare chronic autoimmune neuromuscular disease that cause weakening of the skeletal muscles of the body.
The name myasthenia gravis literally means grave muscle weakness.
What causes myasthenia gravis?
--------------------------------------
Myasthenia gravis interferes in the transmission of nerve impulses to muscles. Normally the nerve endings release a neurotransmitter substance called acetylcholine which then travels to the neuromuscular junction. The aceylcholine binds to acetylcholine receptors which are activated and generate a muscle contraction.
In myasthenia gravis, these antibodies block, modify, or destroy the receptors for acetylcholine at the neuromuscular junction and prevents muscle contraction.
In myasthenia gravis, the thymus gland which is responsible for the production of the immune cells is abnormal.
The thymus gland may give incorrect instructions to developing immune cells, ultimately resulting in the production of the acetylcholine receptor antibodies.
Who is at risk of myasthenia gravis?
-------------------------------------------
Myasthenia gravis occurs at any age usually at age 30-40 in women and 50-60 in men. It occurs more in women than in men.
In rare cases, the foetus may acquire antibodies from a mother affected with myasthenia gravis. Cases of neonatal myasthenia gravis are temporary and the child's symptoms usually disappear within 2-3 months after birth.
Myasthenia gravis is not directly inherited.
Rarely, the disease may occur in more than one member of the same family.
What are the symptoms of myasthenia gravis?
------------------------------------------------------
The typical feature of myasthenia gravis is muscle weakness that increases during periods of activity and improves after periods of rest.
The onset of the disorder is usually sudden.
The weakness may affect any voluntary muscle, muscles which control eye and eyelid movement, facial expression, talking, and swallowing,muscles that control breathing, neck and limb movements:
1.weakness of the eye muscles,a drooping of one or both eyelids (ptosis)2.difficulty in swallowing
3.slurred speech
4.blurred or double vision (diplopia) due to weakness of the muscles controlling eye movements,
5.unstable or waddling gait,
6.weakness in arms, hands, fingers, legs, and neck,
7.a change in facial expression,
8.shortness of breath
9.fatigue
How is the diagnosis of myasthenia gravis made?
----------------------------------------------------------
The diagnosis of myasthenia gravis involve
1.a complete medical history,
2.physical and neurological examinations,especially for impairment of eye movements or muscle weakness without loss of sensation.
3.blood test to detect the presence of acetylcholine receptor antibodies which are abnormally raised in most patients.
4.the edrophonium response test which requires the intravenous administration of edrophonium chloride or Tensilon(r), a drug that blocks the breakdown of acetylcholine and temporarily increases the levels of acetylcholine at the neuromuscular junction. In people with myasthenia gravis, edrophonium chloride will briefly relieve weakness.
5. Electromyographic studies where repetitive nerve stimulation records weakening muscle responses.
6.Computed tomography may be used to identify an abnormal thymus gland or the presence of a thymoma.
7.pulmonary function testing helps to detect abnormal respiratory function which may fail and lead to a myasthenic crisis.
8.A curare test is now rarely done
How is the treatment for myasthenia gravis ?
-----------------------------------------------------
Treatment for myasthenia gravis has improved tremendously with several therapies to help reduce and improve muscle weakness.
1.anticholinesterase agents such as neostigmine and pyridostigmine, which help improve neuromuscular transmission and increase muscle strength.
2.Immunosuppressive drugs such as prednisone, cyclosporine, and azathioprine improve muscle strength by suppressing the production of abnormal antibodies. They must be used cautiously because of their many side effects.
3.Thymectomy, the surgical removal of the thymus gland (usually abnormal in myasthenia gravis), reduces symptoms in more than 70 percent of patients and may cure some individuals, possibly by re-balancing the immune system.
4.plasmapheresis in which abnormal antibodies are removed from the blood, and high-dose intravenous immune globulin, which temporarily modifies the immune system and provides the body with normal antibodies from donated blood.
What are myasthenic crises?
----------------------------------
A myasthenic crisis occurs when the muscles that control breathing weaken to the point that brathing is difficult and requires a respirator for assisted ventilation. It may be triggered by infection, fever, or an adverse reaction to medication.
This condition requires immediate medical attention.
What is the prognosis for myasthenia gravis?
------------------------------------------------------
1.With all these new treatments the prognosis for most patients with myasthenia gravis is good.
2.Many of them will have significant improvement of their muscle weakness.
3.Some cases of myasthenia gravis can go into remission to the extent that medications can be discontinued.
4.Thymectomy hsve resulted in many complete remissions.
5.Life expectancy is not lessened by the disorder.
--------------------------------------------
What is myasthenia gravis?
----------------------------------
Myasthenia gravis is a rare chronic autoimmune neuromuscular disease that cause weakening of the skeletal muscles of the body.
The name myasthenia gravis literally means grave muscle weakness.
What causes myasthenia gravis?
--------------------------------------
Myasthenia gravis interferes in the transmission of nerve impulses to muscles. Normally the nerve endings release a neurotransmitter substance called acetylcholine which then travels to the neuromuscular junction. The aceylcholine binds to acetylcholine receptors which are activated and generate a muscle contraction.
In myasthenia gravis, these antibodies block, modify, or destroy the receptors for acetylcholine at the neuromuscular junction and prevents muscle contraction.
In myasthenia gravis, the thymus gland which is responsible for the production of the immune cells is abnormal.
The thymus gland may give incorrect instructions to developing immune cells, ultimately resulting in the production of the acetylcholine receptor antibodies.
Who is at risk of myasthenia gravis?
-------------------------------------------
Myasthenia gravis occurs at any age usually at age 30-40 in women and 50-60 in men. It occurs more in women than in men.
In rare cases, the foetus may acquire antibodies from a mother affected with myasthenia gravis. Cases of neonatal myasthenia gravis are temporary and the child's symptoms usually disappear within 2-3 months after birth.
Myasthenia gravis is not directly inherited.
Rarely, the disease may occur in more than one member of the same family.
What are the symptoms of myasthenia gravis?
------------------------------------------------------
The typical feature of myasthenia gravis is muscle weakness that increases during periods of activity and improves after periods of rest.
The onset of the disorder is usually sudden.
The weakness may affect any voluntary muscle, muscles which control eye and eyelid movement, facial expression, talking, and swallowing,muscles that control breathing, neck and limb movements:
1.weakness of the eye muscles,a drooping of one or both eyelids (ptosis)2.difficulty in swallowing
3.slurred speech
4.blurred or double vision (diplopia) due to weakness of the muscles controlling eye movements,
5.unstable or waddling gait,
6.weakness in arms, hands, fingers, legs, and neck,
7.a change in facial expression,
8.shortness of breath
9.fatigue
How is the diagnosis of myasthenia gravis made?
----------------------------------------------------------
The diagnosis of myasthenia gravis involve
1.a complete medical history,
2.physical and neurological examinations,especially for impairment of eye movements or muscle weakness without loss of sensation.
3.blood test to detect the presence of acetylcholine receptor antibodies which are abnormally raised in most patients.
4.the edrophonium response test which requires the intravenous administration of edrophonium chloride or Tensilon(r), a drug that blocks the breakdown of acetylcholine and temporarily increases the levels of acetylcholine at the neuromuscular junction. In people with myasthenia gravis, edrophonium chloride will briefly relieve weakness.
5. Electromyographic studies where repetitive nerve stimulation records weakening muscle responses.
6.Computed tomography may be used to identify an abnormal thymus gland or the presence of a thymoma.
7.pulmonary function testing helps to detect abnormal respiratory function which may fail and lead to a myasthenic crisis.
8.A curare test is now rarely done
How is the treatment for myasthenia gravis ?
-----------------------------------------------------
Treatment for myasthenia gravis has improved tremendously with several therapies to help reduce and improve muscle weakness.
1.anticholinesterase agents such as neostigmine and pyridostigmine, which help improve neuromuscular transmission and increase muscle strength.
2.Immunosuppressive drugs such as prednisone, cyclosporine, and azathioprine improve muscle strength by suppressing the production of abnormal antibodies. They must be used cautiously because of their many side effects.
3.Thymectomy, the surgical removal of the thymus gland (usually abnormal in myasthenia gravis), reduces symptoms in more than 70 percent of patients and may cure some individuals, possibly by re-balancing the immune system.
4.plasmapheresis in which abnormal antibodies are removed from the blood, and high-dose intravenous immune globulin, which temporarily modifies the immune system and provides the body with normal antibodies from donated blood.
What are myasthenic crises?
----------------------------------
A myasthenic crisis occurs when the muscles that control breathing weaken to the point that brathing is difficult and requires a respirator for assisted ventilation. It may be triggered by infection, fever, or an adverse reaction to medication.
This condition requires immediate medical attention.
What is the prognosis for myasthenia gravis?
------------------------------------------------------
1.With all these new treatments the prognosis for most patients with myasthenia gravis is good.
2.Many of them will have significant improvement of their muscle weakness.
3.Some cases of myasthenia gravis can go into remission to the extent that medications can be discontinued.
4.Thymectomy hsve resulted in many complete remissions.
5.Life expectancy is not lessened by the disorder.
Thursday, November 15, 2007
A Simple Guide to Trichomoniasis
A Simple Guide to Trichomoniasis
-----------------------------------------
What is Trichomoniasis?
-------------------------------
Trichomoniasis is a common curable sexually transmitted disease caused by the single-celled protozoan parasite, Trichomonas vaginalis.
How is Trichomoniasis spread?
------------------------------------
The parasite is sexually transmitted through penis-to-vagina intercourse with an infected partner.
In women, the vagina is the most common site of infection.
In men the urethra is the most common site of infection.
Women can contract the disease from infected men or women.
Men usually contract it only from infected women.
What are the symptoms of Trichomoniasis?
----------------------------------------------------
Most men with trichomoniasis are symptomless.
Some men may temporarily have an irritation inside the penis, mild discharge, or slight burning after urination or ejaculation.
Women have symptoms of infection which consists of a frothy, yellow-green vaginal discharge with a strong fishy smell.
There may be discomfort during intercourse and urination and irritation and itching of the female genital area.
Cystitis and urethritis can also occur with increased frequency and pain during urination.
Rarely lower abdominal pain can occur.
Pregnant women with trichomoniasis may have babies who are born early or with low birth weight.
How do you diagnose Trichomoniasis?
------------------------------------------------
A physical examination and laboratory test is needed to diagnose trichomoniasis.
The parasite is harder to detect in men than in women.
In women, a pelvic examination can reveal small red ulcerations on the vaginal wall or cervix.
A Pap smear may sometimes show the presence of the trichomonas protozoa.
What is the treatment of Trichomoniasis?
---------------------------------------------------
Trichomoniasis can usually be cured with the prescription drug, metronidazole, given by mouth in a single dose or daily for one week.
It is important for the patient to avoid alcohol with metronidazole and abstain form sex until they and their sex partners complete their treatment and have no symptoms.
Once treated the infection can be cured.
It is important therefore that both partners should be treated at the same time to eliminate the parasite.
Metronidazole can be used to treat pregnant women.
Having trichomoniasis once does not protect a person from getting it again. Following successful treatment, people can still be susceptible to re-infection.
How do you prevent Trichomoniasis?
---------------------------------------------
The surest way to avoid transmission of sexually transmitted diseases is to abstain from sexual contact.
A long-term mutually monogamous relationship with a partner who has been tested and is known to be uninfected is important.
Latex male condoms, when used consistently and correctly, can reduce the risk of transmission of trichomoniasis.
A person diagnosed with trichomoniasis (or any other STD) should receive treatment and should notify all recent sex partners so that they can be treated. This reduces the risk that the sex partners will develop complications from trichomoniasis and reduces the risk that the person with trichomoniasis will become re-infected.
Sex should be stopped until the person with trichomoniasis and all of his or her recent partners complete treatment for trichomoniasis and have no symptoms.
There is no vaccine for Trichomoniasis.
-----------------------------------------
What is Trichomoniasis?
-------------------------------
Trichomoniasis is a common curable sexually transmitted disease caused by the single-celled protozoan parasite, Trichomonas vaginalis.
How is Trichomoniasis spread?
------------------------------------
The parasite is sexually transmitted through penis-to-vagina intercourse with an infected partner.
In women, the vagina is the most common site of infection.
In men the urethra is the most common site of infection.
Women can contract the disease from infected men or women.
Men usually contract it only from infected women.
What are the symptoms of Trichomoniasis?
----------------------------------------------------
Most men with trichomoniasis are symptomless.
Some men may temporarily have an irritation inside the penis, mild discharge, or slight burning after urination or ejaculation.
Women have symptoms of infection which consists of a frothy, yellow-green vaginal discharge with a strong fishy smell.
There may be discomfort during intercourse and urination and irritation and itching of the female genital area.
Cystitis and urethritis can also occur with increased frequency and pain during urination.
Rarely lower abdominal pain can occur.
Pregnant women with trichomoniasis may have babies who are born early or with low birth weight.
How do you diagnose Trichomoniasis?
------------------------------------------------
A physical examination and laboratory test is needed to diagnose trichomoniasis.
The parasite is harder to detect in men than in women.
In women, a pelvic examination can reveal small red ulcerations on the vaginal wall or cervix.
A Pap smear may sometimes show the presence of the trichomonas protozoa.
What is the treatment of Trichomoniasis?
---------------------------------------------------
Trichomoniasis can usually be cured with the prescription drug, metronidazole, given by mouth in a single dose or daily for one week.
It is important for the patient to avoid alcohol with metronidazole and abstain form sex until they and their sex partners complete their treatment and have no symptoms.
Once treated the infection can be cured.
It is important therefore that both partners should be treated at the same time to eliminate the parasite.
Metronidazole can be used to treat pregnant women.
Having trichomoniasis once does not protect a person from getting it again. Following successful treatment, people can still be susceptible to re-infection.
How do you prevent Trichomoniasis?
---------------------------------------------
The surest way to avoid transmission of sexually transmitted diseases is to abstain from sexual contact.
A long-term mutually monogamous relationship with a partner who has been tested and is known to be uninfected is important.
Latex male condoms, when used consistently and correctly, can reduce the risk of transmission of trichomoniasis.
A person diagnosed with trichomoniasis (or any other STD) should receive treatment and should notify all recent sex partners so that they can be treated. This reduces the risk that the sex partners will develop complications from trichomoniasis and reduces the risk that the person with trichomoniasis will become re-infected.
Sex should be stopped until the person with trichomoniasis and all of his or her recent partners complete treatment for trichomoniasis and have no symptoms.
There is no vaccine for Trichomoniasis.
Wednesday, November 14, 2007
A Simple Guide to Human papilloma virus Infection
A Simple Guide to Human papilloma virus Infection
--------------------------------------------------------------
What is Human papilloma virus Infection ?
----------------------------------------------------
Human papilloma virus infection is a sexually transmitted disease that is caused by human papilloma virus (HPV).
Human papilloma virus includes more than 100 different strains.
About 30 of these viruses are sexually transmitted.
They can infect the penis, vulva, anus in men, and the linings of the vagina, cervix, or rectum in women.
Some of these viruses may also cause cancer of the cervix, vulva, vagina, anus, or penis.
How is Human papilloma virus spread?
-----------------------------------------------
The types of HPV that infect the genital area are spread primarily through sexual contact.
Because most HPV infections have no signs or symptoms, many infected persons are unaware they are infected and may transmit the virus to a sex partner.
Very rarely, a pregnant woman can pass HPV to her baby during vaginal delivery. If that happens, the baby usually develops warts in the throat.
What are the Symptoms of Human papilloma virus infection?
-------------------------------------------------------------------------
Most people who have a genital HPV infection do not know they are infected.
The virus lives in the skin or mucous membranes and do not usually cause any symptoms.
Some people get visible genital warts in the vulva, vagina, cervix or rectum in women and on the penis, scrotum, or anus in men.
Genital warts are single or multiple growths or bumps that appear in the genital area, and sometimes are cauliflower shaped.
After sexual contact with an infected person, warts may appear within weeks or months, or not at all.
Some may cause pre-cancerous changes in the cervix, vulva, anus, or penis.
Very rarely, HPV infection results in anal or genital cancers.
How do you diagnose Human papilloma virus infection?
-------------------------------------------------------------------
Genital warts can be diagnosed by visual inspection especially in men.
Most women are diagnosed with HPV on the basis of abnormal Pap tests which can detect cervical cancer or pre-cancerous changes in the cervix.
Many of these changes are related to HPV.
There is also a specific test is available to detect HPV DNA in women.
The test may be used in women with mild Pap test abnormalities.
No HPV tests are available for men.
What is the treatment for Human papilloma virus infection?
-----------------------------------------------------------------------
There is no cure for HPV infection.
In most women the infection goes away on its own.
The treatments provided are directed to the warts and pre-cancerous changes in the cervix(Surgical coning of the cervix).
Visible genital warts can be removed by medications the patient applies such as Podophyllin,Imiquimod cream, 5-fluorouracil cream ,Trichloroacetic acid (TCA) .
Podophyllin and 5-fluorouracil cream should not be used in pregnant women because these may cause deformity in the baby.
Small warts can be removed by one of three methods.
Freezing (cryosurgery)
Burning (electrocautery)
Laser treatment
Large warts may require surgery.
Although the above treatments may remove the visible warts, the virus may still be in the body and recurrence may occur.
Sometimes the warts will disappear on their own.
If that happens, nothing else need to be done.
What are the complications of Human papilloma virus infection?
-----------------------------------------------------------------------------
All types of HPV can cause mild Pap test abnormalities which may not be serious.
In most cases (90 percent), cervical HPV infection in women becomes undetectable within two years.
Only a small proportion of women have persistent infection.
About 10 of the 30 identified genital HPV types can lead to the rare development of cervical cancer.
How do you prevent Human papilloma virus infection?
------------------------------------------------------------------
Education and counseling of persons at risk on ways to avoid STDs through changes in sexual behaviors:
1.The surest way to eliminate risk for genital HPV infection is to refrain from any sexual contact with another individual.
2.A long-term, mutually monogamous relationship with an uninfected partner is the prevention for future genital HPV infections.
3.The use of a latex condom has been associated with a lower rate of cervical cancer which is related to HPV disease.
4.Follow up is important in order to watch for recurrences which can occur most frequently during the first 3 months after treatment.
Pap smear screening of women every 3-6 months is important to check for recurrences.
5. preexposure vaccination of persons at risk for HPV infection.
The new vaccine Gardasil is effective against HPV types 16 and 18 which cause approximately 70% of cervical cancers, and against HPV types 6 and 11 which cause approximately 90% of genital warts.
Added 4th October 2008
-----------------------------------
The most common HPV types causing 70% of all cervical cancers are the HPV 16,18, 31 and 45.
Both new vaccines against HPV Cervarix and Gardasil are equally effective in producing high antibodies against HPV 16 and 18 and preventing these infections over a 5 year period.
However prevention of the HPV 16 and 18 does not mean the cervical cancer can be abolished totally.
--------------------------------------------------------------
What is Human papilloma virus Infection ?
----------------------------------------------------
Human papilloma virus infection is a sexually transmitted disease that is caused by human papilloma virus (HPV).
Human papilloma virus includes more than 100 different strains.
About 30 of these viruses are sexually transmitted.
They can infect the penis, vulva, anus in men, and the linings of the vagina, cervix, or rectum in women.
Some of these viruses may also cause cancer of the cervix, vulva, vagina, anus, or penis.
How is Human papilloma virus spread?
-----------------------------------------------
The types of HPV that infect the genital area are spread primarily through sexual contact.
Because most HPV infections have no signs or symptoms, many infected persons are unaware they are infected and may transmit the virus to a sex partner.
Very rarely, a pregnant woman can pass HPV to her baby during vaginal delivery. If that happens, the baby usually develops warts in the throat.
What are the Symptoms of Human papilloma virus infection?
-------------------------------------------------------------------------
Most people who have a genital HPV infection do not know they are infected.
The virus lives in the skin or mucous membranes and do not usually cause any symptoms.
Some people get visible genital warts in the vulva, vagina, cervix or rectum in women and on the penis, scrotum, or anus in men.
Genital warts are single or multiple growths or bumps that appear in the genital area, and sometimes are cauliflower shaped.
After sexual contact with an infected person, warts may appear within weeks or months, or not at all.
Some may cause pre-cancerous changes in the cervix, vulva, anus, or penis.
Very rarely, HPV infection results in anal or genital cancers.
How do you diagnose Human papilloma virus infection?
-------------------------------------------------------------------
Genital warts can be diagnosed by visual inspection especially in men.
Most women are diagnosed with HPV on the basis of abnormal Pap tests which can detect cervical cancer or pre-cancerous changes in the cervix.
Many of these changes are related to HPV.
There is also a specific test is available to detect HPV DNA in women.
The test may be used in women with mild Pap test abnormalities.
No HPV tests are available for men.
What is the treatment for Human papilloma virus infection?
-----------------------------------------------------------------------
There is no cure for HPV infection.
In most women the infection goes away on its own.
The treatments provided are directed to the warts and pre-cancerous changes in the cervix(Surgical coning of the cervix).
Visible genital warts can be removed by medications the patient applies such as Podophyllin,Imiquimod cream, 5-fluorouracil cream ,Trichloroacetic acid (TCA) .
Podophyllin and 5-fluorouracil cream should not be used in pregnant women because these may cause deformity in the baby.
Small warts can be removed by one of three methods.
Freezing (cryosurgery)
Burning (electrocautery)
Laser treatment
Large warts may require surgery.
Although the above treatments may remove the visible warts, the virus may still be in the body and recurrence may occur.
Sometimes the warts will disappear on their own.
If that happens, nothing else need to be done.
What are the complications of Human papilloma virus infection?
-----------------------------------------------------------------------------
All types of HPV can cause mild Pap test abnormalities which may not be serious.
In most cases (90 percent), cervical HPV infection in women becomes undetectable within two years.
Only a small proportion of women have persistent infection.
About 10 of the 30 identified genital HPV types can lead to the rare development of cervical cancer.
How do you prevent Human papilloma virus infection?
------------------------------------------------------------------
Education and counseling of persons at risk on ways to avoid STDs through changes in sexual behaviors:
1.The surest way to eliminate risk for genital HPV infection is to refrain from any sexual contact with another individual.
2.A long-term, mutually monogamous relationship with an uninfected partner is the prevention for future genital HPV infections.
3.The use of a latex condom has been associated with a lower rate of cervical cancer which is related to HPV disease.
4.Follow up is important in order to watch for recurrences which can occur most frequently during the first 3 months after treatment.
Pap smear screening of women every 3-6 months is important to check for recurrences.
5. preexposure vaccination of persons at risk for HPV infection.
The new vaccine Gardasil is effective against HPV types 16 and 18 which cause approximately 70% of cervical cancers, and against HPV types 6 and 11 which cause approximately 90% of genital warts.
Added 4th October 2008
-----------------------------------
The most common HPV types causing 70% of all cervical cancers are the HPV 16,18, 31 and 45.
Both new vaccines against HPV Cervarix and Gardasil are equally effective in producing high antibodies against HPV 16 and 18 and preventing these infections over a 5 year period.
However prevention of the HPV 16 and 18 does not mean the cervical cancer can be abolished totally.
Tuesday, November 13, 2007
A Simple Guide to Anthrax
A Simple Guide to Anthrax
--------------------------------
What is Anthrax?
---------------------
Anthrax is a disease caused by a gram positive spore forming bacterium that primarily infects mainly animals but can cause serious illness in humans if one is exposed to these spores.
It can affect the skin, the intestines or the lungs.
What are the different forms of Anthrax?
-----------------------------------------------
1.Cutaneous anthrax is the most common type of anthrax.
It occurs 1-2 days after the skin is scratched and exposed to soil, animal parts or faeces containing the spores of Anthrax.
The affected skin forms an itchy black swelling that becomes a blister that breaks into an ulcer.
The bacteria can then enter the bloodstream and cause septicaemia (blood poisoning). 20% of cases will die if they are not treated promptly.
2.Intestinal anthrax happens 2 to 5 days after one eats contaminated meat containing the spores.
The intestinal lining breaks and bleeding occurs. The victim feels nausea, loss of appetite, vomiting, fever and suffers from severe abdominal pain, bloody vomiting and diarrhoea.
Blood poisoning occurs and the loss of blood can result in shock.
25% to 75% of cases will eventually die.
3.Inhalation anthrax is the least common of the 3 types.
However it is the most serious form of anthrax because the spores are inhaled into the lungs.
Flu-like symptoms occur for 2 to 3 days with fever, cough and then breathlessness starts.
Then the lungs starts to bleed internally like a person drowning in his own blood. Death occurs rapidly most of the time.
This is the type that is used as a biological weapon by terrorists who will send the spores by envelopes to their victims.
What is the treatment of Anthrax?
-----------------------------------------
The bacterium is easily killed by several antibiotics(penicillin,tetracycline etc), the most effective one being ciprofloxacin given intravenously or directly into the bloodstream.
Oral ciprofloxacin is also effective in less severe cases.
There is no need to take antibiotics to prevent anthrax.
Doing so may cause the bacteria to become resistant to the antibiotic and make it more difficult to treat.
A cell-free vaccine has been developed for people who are at risk of contracting anthrax. This vaccine may be mass produced in the future for common use.
Although anthrax is a much feared disease, it can be prevented and treated with careful and alert practices.
Its use as a biological warfare agent is currently very limited with very effective counter measures in place.
Monday, November 12, 2007
A Simple Guide to Gonorrhea
A Simple Guide to Gonorrhea
-----------------------------------
What is Gonorrhea?
------------------------
Gonorrhea is a sexually transmitted disease caused by the gram negative bacteria Neisseria gonorrhoeae.
How is gonorrhea spread?
-----------------------------
Gonorrhea is a very common infectious disease, a bacterium that can grow and multiply easily in the warm, moist areas of the reproductive tract, including the cervix, uterus and fallopian tubes in women, and in the urethra in women and men.
The bacterium can also grow in the mouth, throat, eyes, and anus.
Gonorrhea is spread by infected people through contact with the penis, vagina, mouth, or anus.
There is no life long immunity after tratment with Gonorrhea.
A person who has been treated for gonorrhea may get infected again if there is sexual contact with a person infected with gonorrhea.
Gonorrhea can also be spread from mother to baby during delivery.
Who is at risk for gonorrhea?
-----------------------------------
Any sexually active person can be infected with gonorrhea if their partner has the disease.
What are the symptoms of gonorrhea?
---------------------------------------------
A high percentage of men with gonorrhea do not have any symptoms at all.
Some men have some symptoms that appear two to five days after infection.
Symptoms include
1.a burning sensation when urinating, or a white, yellow, or green discharge from the penis.
2. painful or swollen testicles.
In women the symptoms of gonorrhea are often mild.
Most women who are infected have no symptoms.
The initial symptoms in women include
1.a painful or burning sensation when urinating,
2.increased vaginal discharge,
3.vaginal bleeding between periods.
4.lower abdominal pain due to salpingitis(infected fallopian tubes)
Women with gonorrhea are at risk of developing serious complications from the infection.
Symptoms of rectal infection in both men and women may include discharge, anal itching, soreness, bleeding, or painful bowel movements.
Most of the time rectal infection do not cause symptoms.
Infections in the throat may cause a sore throat.
Usually there are no symptoms.
How does gonorrhea affect a pregnant woman and her baby?
-----------------------------------------------------------------------
A pregnant woman with gonorrhea may give the infection to her baby as the baby passes through the birth canal during delivery.
This can cause blindness, joint infection, or a life-threatening blood infection in the baby.
Treatment of gonorrhea should be started as soon as it is detected in pregnant women.
How is gonorrhea diagnosed?
-----------------------------------
There are several laboratory tests available to diagnose gonorrhea:
1. a swab may be taken from cervix, urethra, rectum, or throat for testing
2. A direct Gram smear test of a sample from a urethra or a cervix allows the doctor in the clinic to see the gonorrhea bacterium under a microscope.
3. blood test can also detect the presence of gonorrhea in the blood stream
What is the treatment for gonorrhea?
--------------------------------------------
There are several antibiotics(penicillin, tetracyclines, spectinomycin) which can successfully cure gonorrhea in adolescents and adults.
Drug-resistant strains of gonorrhea are increasing in many areas of the world and successful treatment of gonorrhea is becoming more difficult.
Sometimes people with gonorrhea also have chlamydia.
Antibiotics for both infections are usually given together.
Persons with gonorrhea should be tested for other STDs.
It is advisable to take all of the medication prescribed to cure gonorrhea.
People who have had gonorrhea and have been treated can get the disease a second time if they have sexual contact with persons infected with gonorrhea.
What are the complications of gonorrhea?
--------------------------------------------------
Untreated gonorrhea can cause serious and permanent complications in both women and men.
In women, gonorrhea is a common cause of pelvic inflammatory disease (PID).
Women with PID may not have symptoms.
Symptoms when present can be very severe and can include abdominal pain and fever.
PID can cause internal abscesses in the pelvis which can give rise to long-lasting, chronic pelvic pain.
PID can damage the fallopian tubes enough to cause infertility and the risk of ectopic pregnancy.
Ectopic pregnancy is a life-threatening condition in which a fertilized egg grows outside the uterus, usually in a fallopian tube, sometimes in the abdomen.
In men gonorrhea can cause epididymitis, a painful infection of the testicles that can lead to infertility if left untreated.
Prostatits(infection of prostate), seminal vesiculitis and chronic urethral infection may be associated with fever and lead to urethral strictures causing difficulty in passing urine.
People with gonorrhea are more likely to contract HIV the virus that causes AIDS.
Gonorrhea can spread to the blood, joints or eyes(uveitis).
Blood infection or septicemia can be life threatening.
How can gonorrhea be prevented?
-----------------------------------------
The best way to avoid transmission of sexually transmitted diseases is to abstain from sexual intercourse.
He or she should be in a long-term mutually monogamous relationship with a partner who has been tested and is known to be uninfected.
Latex condoms, when used consistently and correctly, can reduce the risk of transmission of gonorrhea.
Any genital symptoms such as discharge or burning sensation during urination or unusual sore or rash should be a signal to stop having sex.
A person who has been diagnosed and treated for gonorrhea should notify all recent sex partners so they can also be treated.
In this way there is less risk that the sexual partners will develop serious complications from gonorrhea.
It will also reduce the person's risk of becoming re-infected.
The person and all of his or her sex partners must avoid sex until they have completed their treatment for gonorrhea.
-----------------------------------
What is Gonorrhea?
------------------------
Gonorrhea is a sexually transmitted disease caused by the gram negative bacteria Neisseria gonorrhoeae.
How is gonorrhea spread?
-----------------------------
Gonorrhea is a very common infectious disease, a bacterium that can grow and multiply easily in the warm, moist areas of the reproductive tract, including the cervix, uterus and fallopian tubes in women, and in the urethra in women and men.
The bacterium can also grow in the mouth, throat, eyes, and anus.
Gonorrhea is spread by infected people through contact with the penis, vagina, mouth, or anus.
There is no life long immunity after tratment with Gonorrhea.
A person who has been treated for gonorrhea may get infected again if there is sexual contact with a person infected with gonorrhea.
Gonorrhea can also be spread from mother to baby during delivery.
Who is at risk for gonorrhea?
-----------------------------------
Any sexually active person can be infected with gonorrhea if their partner has the disease.
What are the symptoms of gonorrhea?
---------------------------------------------
A high percentage of men with gonorrhea do not have any symptoms at all.
Some men have some symptoms that appear two to five days after infection.
Symptoms include
1.a burning sensation when urinating, or a white, yellow, or green discharge from the penis.
2. painful or swollen testicles.
In women the symptoms of gonorrhea are often mild.
Most women who are infected have no symptoms.
The initial symptoms in women include
1.a painful or burning sensation when urinating,
2.increased vaginal discharge,
3.vaginal bleeding between periods.
4.lower abdominal pain due to salpingitis(infected fallopian tubes)
Women with gonorrhea are at risk of developing serious complications from the infection.
Symptoms of rectal infection in both men and women may include discharge, anal itching, soreness, bleeding, or painful bowel movements.
Most of the time rectal infection do not cause symptoms.
Infections in the throat may cause a sore throat.
Usually there are no symptoms.
How does gonorrhea affect a pregnant woman and her baby?
-----------------------------------------------------------------------
A pregnant woman with gonorrhea may give the infection to her baby as the baby passes through the birth canal during delivery.
This can cause blindness, joint infection, or a life-threatening blood infection in the baby.
Treatment of gonorrhea should be started as soon as it is detected in pregnant women.
How is gonorrhea diagnosed?
-----------------------------------
There are several laboratory tests available to diagnose gonorrhea:
1. a swab may be taken from cervix, urethra, rectum, or throat for testing
2. A direct Gram smear test of a sample from a urethra or a cervix allows the doctor in the clinic to see the gonorrhea bacterium under a microscope.
3. blood test can also detect the presence of gonorrhea in the blood stream
What is the treatment for gonorrhea?
--------------------------------------------
There are several antibiotics(penicillin, tetracyclines, spectinomycin) which can successfully cure gonorrhea in adolescents and adults.
Drug-resistant strains of gonorrhea are increasing in many areas of the world and successful treatment of gonorrhea is becoming more difficult.
Sometimes people with gonorrhea also have chlamydia.
Antibiotics for both infections are usually given together.
Persons with gonorrhea should be tested for other STDs.
It is advisable to take all of the medication prescribed to cure gonorrhea.
People who have had gonorrhea and have been treated can get the disease a second time if they have sexual contact with persons infected with gonorrhea.
What are the complications of gonorrhea?
--------------------------------------------------
Untreated gonorrhea can cause serious and permanent complications in both women and men.
In women, gonorrhea is a common cause of pelvic inflammatory disease (PID).
Women with PID may not have symptoms.
Symptoms when present can be very severe and can include abdominal pain and fever.
PID can cause internal abscesses in the pelvis which can give rise to long-lasting, chronic pelvic pain.
PID can damage the fallopian tubes enough to cause infertility and the risk of ectopic pregnancy.
Ectopic pregnancy is a life-threatening condition in which a fertilized egg grows outside the uterus, usually in a fallopian tube, sometimes in the abdomen.
In men gonorrhea can cause epididymitis, a painful infection of the testicles that can lead to infertility if left untreated.
Prostatits(infection of prostate), seminal vesiculitis and chronic urethral infection may be associated with fever and lead to urethral strictures causing difficulty in passing urine.
People with gonorrhea are more likely to contract HIV the virus that causes AIDS.
Gonorrhea can spread to the blood, joints or eyes(uveitis).
Blood infection or septicemia can be life threatening.
How can gonorrhea be prevented?
-----------------------------------------
The best way to avoid transmission of sexually transmitted diseases is to abstain from sexual intercourse.
He or she should be in a long-term mutually monogamous relationship with a partner who has been tested and is known to be uninfected.
Latex condoms, when used consistently and correctly, can reduce the risk of transmission of gonorrhea.
Any genital symptoms such as discharge or burning sensation during urination or unusual sore or rash should be a signal to stop having sex.
A person who has been diagnosed and treated for gonorrhea should notify all recent sex partners so they can also be treated.
In this way there is less risk that the sexual partners will develop serious complications from gonorrhea.
It will also reduce the person's risk of becoming re-infected.
The person and all of his or her sex partners must avoid sex until they have completed their treatment for gonorrhea.
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.
Friday, November 9, 2007
A Simple Guide to Genital Herpes
A Simple Guide to Genital Herpes
----------------------------------------
What is Genital Herpes?
-----------------------------
Genital herpes is a sexually transmitted disease caused by the herpes simplex viruses type 1 (HSV-1) and type 2 (HSV-2).
Most genital herpes is caused by HSV-2.
Incubation peroid is 14 days to several weeks.
What are the symptoms of Genital Herpes?
--------------------------------------------------
Most infected patients do not have any signs or symptoms from Genital herpes infection.
In the male, small blisters occur on the penis glans and on both of the scrotums.
If the urethra is involved. there may be discharge and pain on urination.
In the female, there may be one or more blisters on or around the genitals or rectum. The blisters normally break, leaving painful ulcers which may take two to four weeks to heal.
Typically, recurrence of the blisters may appear weeks or months after the first and is usually less severe and shorter than the first outbreak.
The infection can stay in the body indefinitely with the number of outbreaks decreasing over a period of years.
How is Genital Herpes spread?
-------------------------------------
Genital herpes is usaully a sexually transmitted disease.
Genital HSV-2 infection is more common in women (25%) than in men (20%).
This may be due to male-to-female transmissions.
HSV-1 and HSV-2 viruses can be found in and released from the blisters and ulcers that the viruses cause.
They also are released between outbreaks from skin that does not appear to be broken or to have a sore.
Transmission can occur from an infected partner who does not have a visible sore and may not know that he or she is infected.
HSV-1 can also cause genital herpes.
It however causes more infections of the mouth and lips, so-called "cold sores."
HSV-1 infection of the genitals can be caused by oral-genital or genital-genital contact with a person who has HSV-1 infection.
Genital HSV-1 outbreaks does not recur as often as genital HSV-2 outbreaks.
How do you diagnose Genital Herpes?
--------------------------------------------
The signs and symptoms of HSV-2 infection may be none to obvious.
Doctors can diagnose genital herpes by visual examination if the outbreak is typical and by taking a sample from the sores and testing it in a laboratory.
HSV infections can be difficult to diagnose between outbreaks.
The best way to confirm the presence of Genital herpes is to do a blood test for HSV1 and HSV2 viruses. The results however may not 100% accurate.
Most people infected with genital herpes do not know of their infection.
Once the virus is transmitted, an outbreak usually occurs within two weeks and the sores typically heal within two to four weeks.
During the primary episode, signs and symptoms may include a second episode of sores and sometimes fever and swollen glands.
Most individuals with HSV-2 infection do not have sores, or the sores may be so mild that they do not even notice.
Most people diagnosed with a first episode of genital herpes can expect to have several symptomatic recurrences within a year.
Usually these recurrences decrease in frequency.
What is the treatment of Genital Herpes?
-------------------------------------------------
There is no treatment that can cure herpes but antiviral medications like acyclovir can shorten and prevent outbreaks during the period of time the person takes the medication.
In addition the medications can reduce transmission to partners.
How do you prevent Genital Herpes?
-------------------------------------------
1.abstainance from sexual contact, or to be in a long-term mutually monogamous relationship with a partner who has been tested and is known to be uninfected from genital herpes.
2.protection using a latex condom during sexual contact. However since a condom may not cover all infected areas, even correct and consistent use of latex condoms cannot guarantee protection from genital herpes.
3.Persons with herpes should abstain from sexual activity with uninfected partners.
This is a very important moral responsibility.
Sex partners of infected persons should be advised that they may become infected.
Sex partners can seek testing to determine if they are infected with HSV.
A positive HSV-2 blood test most likely indicates a genital herpes infection.
What are the Complications of Genital herpes?
--------------------------------------------------------
1.In some cases, genital herpes can cause recurrent painful genital sores in many adults.
2.Herpes infection can be severe in people with suppressed immune systems eg. HIV.
3.psychological distress may occur in people who know they are infected because the herpes is not curable.
4.genital HSV can cause potentially fatal infections in babies.
If a woman has active genital herpes at delivery, a cesarean delivery is usually performed.
Infection of a baby from a woman with herpes infection fortunately is rare.
5.Herpes may play a role in the spread of HIV the virus that causes AIDS. Herpes can make people more susceptible to HIV infection, and it can make HIV-infected individuals more infectious to others.
----------------------------------------
What is Genital Herpes?
-----------------------------
Genital herpes is a sexually transmitted disease caused by the herpes simplex viruses type 1 (HSV-1) and type 2 (HSV-2).
Most genital herpes is caused by HSV-2.
Incubation peroid is 14 days to several weeks.
What are the symptoms of Genital Herpes?
--------------------------------------------------
Most infected patients do not have any signs or symptoms from Genital herpes infection.
In the male, small blisters occur on the penis glans and on both of the scrotums.
If the urethra is involved. there may be discharge and pain on urination.
In the female, there may be one or more blisters on or around the genitals or rectum. The blisters normally break, leaving painful ulcers which may take two to four weeks to heal.
Typically, recurrence of the blisters may appear weeks or months after the first and is usually less severe and shorter than the first outbreak.
The infection can stay in the body indefinitely with the number of outbreaks decreasing over a period of years.
How is Genital Herpes spread?
-------------------------------------
Genital herpes is usaully a sexually transmitted disease.
Genital HSV-2 infection is more common in women (25%) than in men (20%).
This may be due to male-to-female transmissions.
HSV-1 and HSV-2 viruses can be found in and released from the blisters and ulcers that the viruses cause.
They also are released between outbreaks from skin that does not appear to be broken or to have a sore.
Transmission can occur from an infected partner who does not have a visible sore and may not know that he or she is infected.
HSV-1 can also cause genital herpes.
It however causes more infections of the mouth and lips, so-called "cold sores."
HSV-1 infection of the genitals can be caused by oral-genital or genital-genital contact with a person who has HSV-1 infection.
Genital HSV-1 outbreaks does not recur as often as genital HSV-2 outbreaks.
How do you diagnose Genital Herpes?
--------------------------------------------
The signs and symptoms of HSV-2 infection may be none to obvious.
Doctors can diagnose genital herpes by visual examination if the outbreak is typical and by taking a sample from the sores and testing it in a laboratory.
HSV infections can be difficult to diagnose between outbreaks.
The best way to confirm the presence of Genital herpes is to do a blood test for HSV1 and HSV2 viruses. The results however may not 100% accurate.
Most people infected with genital herpes do not know of their infection.
Once the virus is transmitted, an outbreak usually occurs within two weeks and the sores typically heal within two to four weeks.
During the primary episode, signs and symptoms may include a second episode of sores and sometimes fever and swollen glands.
Most individuals with HSV-2 infection do not have sores, or the sores may be so mild that they do not even notice.
Most people diagnosed with a first episode of genital herpes can expect to have several symptomatic recurrences within a year.
Usually these recurrences decrease in frequency.
What is the treatment of Genital Herpes?
-------------------------------------------------
There is no treatment that can cure herpes but antiviral medications like acyclovir can shorten and prevent outbreaks during the period of time the person takes the medication.
In addition the medications can reduce transmission to partners.
How do you prevent Genital Herpes?
-------------------------------------------
1.abstainance from sexual contact, or to be in a long-term mutually monogamous relationship with a partner who has been tested and is known to be uninfected from genital herpes.
2.protection using a latex condom during sexual contact. However since a condom may not cover all infected areas, even correct and consistent use of latex condoms cannot guarantee protection from genital herpes.
3.Persons with herpes should abstain from sexual activity with uninfected partners.
This is a very important moral responsibility.
Sex partners of infected persons should be advised that they may become infected.
Sex partners can seek testing to determine if they are infected with HSV.
A positive HSV-2 blood test most likely indicates a genital herpes infection.
What are the Complications of Genital herpes?
--------------------------------------------------------
1.In some cases, genital herpes can cause recurrent painful genital sores in many adults.
2.Herpes infection can be severe in people with suppressed immune systems eg. HIV.
3.psychological distress may occur in people who know they are infected because the herpes is not curable.
4.genital HSV can cause potentially fatal infections in babies.
If a woman has active genital herpes at delivery, a cesarean delivery is usually performed.
Infection of a baby from a woman with herpes infection fortunately is rare.
5.Herpes may play a role in the spread of HIV the virus that causes AIDS. Herpes can make people more susceptible to HIV infection, and it can make HIV-infected individuals more infectious to others.
Wednesday, November 7, 2007
A Simple Guide to Hepatitis A
A Simple Guide to Hepatitis A
-----------------------------------
What is Hepatitis A?
-------------------------
Hepatitis A is a acute inflammatory infection of the liver which is caused by the hepatitis A virus(HAV).
How is Hepatitis A virus spread?
--------------------------------------
The virus is excreted in faeces and transmitted through contaminated food and water. Eating shellfish, cockle shells, prawns or crabs taken from sewage-contaminated water is a common means of contracting hepatitis A.
It can also be acquired by close contact with individuals infected with the virus.
HAV causes the liver to become enlarged, inflamed and tender resulting in all the symptoms of hepatitis.
There is no chronic (long-term) infection.
What are the Symptoms of Hepatitis A?
----------------------------------------------
A person is infectious for 2-3 weeks before he or she experiences symptoms:
1.fever and joint pains
2.jaundice
3.fatigue
4.loss of appetite
5.nausea and vomiting
6.abdominal pain
7.pale coloured stools and dark urine
8.itchy skin due to irritation by the bilirubin.
During the first week of the illness he feels very sick and weak.
As the condition improves, the patient generally feels better after the first week but may requires to rest at home for 6 weeks to avoid damage to the liver.
How is the diagnosis of Hepatitis A made?
-------------------------------------------------
A blood test is the best way to diagnose hepatitis A.
His hepatitis antigens are raised at the early stage but as his condition improves the antibodies become positive.
His liver function tests are also done to assess the damage to the liver.
Usually the serum bilirubin is high, liver enzymes or tramsaminase, alkaline phosphatase are raised in the acute stage of illness.
As the condition improves, these tests gradually returned to normal.
What is the Treatment of Hepatitis A?
---------------------------------------------
There are no medicines for treatment of Hepatitis A except for symptomatic treatment of symptoms.
1.Rest in bed
2.multivitamins especially vitamin B to improve the function of the liver
3.Lots of fluids
4.carbohydrate diet
5.Anti-itch creams and lotions to stop itch
Recovery is usual with very rare cases going on to cirrhosis of the liver.
What is the Prevention of Hepatitis A?
---------------------------------------------
Hepatitis A vaccination is the best protection.
It is usually given in 2 doses within 1 year.
Immune globulin can be given for short-term protection.
It is given before and within 2 weeks after coming in contact with hepatitis A virus.
The vaccine is recommended for travellers travelling to developing countries and people with chronic liver disease.
Always practice good food hygiene.
Avoid food like seafood which may be contaminated by unhygienic water.
Always wash your hands with soap and water after using the toilet, before preparing and eating food.
Recovery is usual within 6 weeks.
What is the difference between Hepatitis A and Hepatitis B?
----------------------------------------------------------------------
Hepatitis A is spread through eating food contaminated with the HAV virus.
Examples include partially cooked shellfish (oysters, clams) or in situations where there is poor hygiene (food/drink/utensils contaminated with an infected person's faeces).
Most people suffer an acute episode and upon recovery have immunity to Hepatitis A.
Hepatitis B is spread by contact with blood or body/fluids of an infected person (including a carrier) or from a carrier mother to her newborn during childbirth.
Hepatitis B infection can lead to hepatitis carrier stage or chronic hepatitis which can results in liver cirrhosis or cancer.
-----------------------------------
What is Hepatitis A?
-------------------------
Hepatitis A is a acute inflammatory infection of the liver which is caused by the hepatitis A virus(HAV).
How is Hepatitis A virus spread?
--------------------------------------
The virus is excreted in faeces and transmitted through contaminated food and water. Eating shellfish, cockle shells, prawns or crabs taken from sewage-contaminated water is a common means of contracting hepatitis A.
It can also be acquired by close contact with individuals infected with the virus.
HAV causes the liver to become enlarged, inflamed and tender resulting in all the symptoms of hepatitis.
There is no chronic (long-term) infection.
What are the Symptoms of Hepatitis A?
----------------------------------------------
A person is infectious for 2-3 weeks before he or she experiences symptoms:
1.fever and joint pains
2.jaundice
3.fatigue
4.loss of appetite
5.nausea and vomiting
6.abdominal pain
7.pale coloured stools and dark urine
8.itchy skin due to irritation by the bilirubin.
During the first week of the illness he feels very sick and weak.
As the condition improves, the patient generally feels better after the first week but may requires to rest at home for 6 weeks to avoid damage to the liver.
How is the diagnosis of Hepatitis A made?
-------------------------------------------------
A blood test is the best way to diagnose hepatitis A.
His hepatitis antigens are raised at the early stage but as his condition improves the antibodies become positive.
His liver function tests are also done to assess the damage to the liver.
Usually the serum bilirubin is high, liver enzymes or tramsaminase, alkaline phosphatase are raised in the acute stage of illness.
As the condition improves, these tests gradually returned to normal.
What is the Treatment of Hepatitis A?
---------------------------------------------
There are no medicines for treatment of Hepatitis A except for symptomatic treatment of symptoms.
1.Rest in bed
2.multivitamins especially vitamin B to improve the function of the liver
3.Lots of fluids
4.carbohydrate diet
5.Anti-itch creams and lotions to stop itch
Recovery is usual with very rare cases going on to cirrhosis of the liver.
What is the Prevention of Hepatitis A?
---------------------------------------------
Hepatitis A vaccination is the best protection.
It is usually given in 2 doses within 1 year.
Immune globulin can be given for short-term protection.
It is given before and within 2 weeks after coming in contact with hepatitis A virus.
The vaccine is recommended for travellers travelling to developing countries and people with chronic liver disease.
Always practice good food hygiene.
Avoid food like seafood which may be contaminated by unhygienic water.
Always wash your hands with soap and water after using the toilet, before preparing and eating food.
Recovery is usual within 6 weeks.
What is the difference between Hepatitis A and Hepatitis B?
----------------------------------------------------------------------
Hepatitis A is spread through eating food contaminated with the HAV virus.
Examples include partially cooked shellfish (oysters, clams) or in situations where there is poor hygiene (food/drink/utensils contaminated with an infected person's faeces).
Most people suffer an acute episode and upon recovery have immunity to Hepatitis A.
Hepatitis B is spread by contact with blood or body/fluids of an infected person (including a carrier) or from a carrier mother to her newborn during childbirth.
Hepatitis B infection can lead to hepatitis carrier stage or chronic hepatitis which can results in liver cirrhosis or cancer.
Tuesday, November 6, 2007
A Simple Guide to Hepatitis B
A Simple Guide to Hepatitis B
------------------------------------
What is Hepatitis B?-
-------------------------
Hepatitis B is a serious chronic inflammatory liver disease caused by a virus which is called hepatitis B virus (HBV).
What are the Symptoms of Hepatitis B?
----------------------------------------------
Most of the time a person with HBV infection has no symptoms at all.
Older people are more likely to have symptoms.
If you have symptoms, they might include :
1.jaundice (yellowing of the skin and white of eye)
2.dark coloured urine
3.pale stools
4.prolonged tiredness
5.nausea and vomiting.
6.loss of appetite
7.abdominal pain
8.fever and joint pains
How is the diagnosis of Hepatitis made?
-----------------------------------------------
A blood test is the only way to diagnose hepatitis B.
You may be infected with HBV and may even spread it to others without knowing it.
HBV can be spread from an infected mother to her infant during birth.
To prevent spread of HBV from infected mothers to their infants, every woman should have her blood tested for hepatitis B surface antigen (HBsAg) during each pregnancy.
What is the treatment of Hepatitis B?
-------------------------------------------
There are no medications available for recently acquired (acute) HBV infection. There are antiviral drugs eg interferon which may be able to treat chronic HBV infection.
Who is at risk of getting Hepatitis B?
-------------------------------------------
For those who has never been immunised or do not have antibodies from having a previous Hepatitis B infection, you are at risk of Hepatitis B infection.
The Hepatitis B virus is is not spread through food or water, sharing eating utensils, breastfeeding, hugging, coughing, sneezing, or skin contact.
HBV is spread by exposure to infected blood from skin puncture or contact with mucous membranes.
It is spread by:
1.sexual contact with an infected person
2.an infected mother to her newborn during childbirth
3.a Hepatitis B infected person's blood during blood transfusion
4.sharing of injection needles among drug abusers
5.accidental cuts to the skin by a nail clipper, shaving blade or other instruments that are contaminated with a Hepatitis B infected person's blood
6.contact with an infected person's saliva or blood through cuts or sores in the mouth or skin. Kissing by itself do not spread HBV unless there is a cut in the lips.
7.during acupuncture, body or ear piercing and tattooing if the needles used are contaminated with Hepatitis B infected person's blood
8.have a job that involves contact with human blood or body fluids
What is the best prevention for Hepatitis B?
----------------------------------------------------
Hepatitis B vaccine is the best prevention against hepatitis B.
If you do not have antibodies from a previous infection and if you are not a Hepatitis B carrier, you can get vaccinated against Hepatitis B and protect yourself from its complications.
Hepatitis B vaccine is recommended for all infants, for children and adolescents who were not vaccinated as infants, and for all unvaccinated adults who are at risk for HBV infection as well as any adult who wants to be protected against HBV infection.
The vaccine is safe.
It is also extremely effective provided you complete all 3 doses:
1st dose - at the appointed date
2nd dose - 1 month after the 1st dose
3rd dose - 5 months after the 2nd dose
A booster vaccination may be necessary after 5 years if the blood test showed a drop in immunity.
Infants born to infected mothers need to get hepatitis B vaccine and another shot call HBIG (hepatitis B immune globulin) soon after birth to prevent infection.
Besides vaccination, other ways to prevent transmission of HBV are:
1.avoid multiple sexual partners; keep to one sexual partner
2.Latex condoms, when used consistently and correctly, may reduce the risk of sexually transmitted HBV transmission.
3.Do not inject illegal drugs. Never share needles, syringes or drugs.
4.Do not share personal items like razors, toothbrushes or any other instruments that may cause tears to the skin and hence spread of any blood borne infection.
5.seek reliable operators for ear or body piercing, tattooing or acupuncture.
What happens if I am a Hepatitis B carrier?
--------------------------------------------------
A simple blood test can tell if you are a carrier, are immune or need immunisation.
If you are found to be a carrier, then:
1.you will need to see your doctor every 6 months to a year for tests to check your liver function and blood alpha-foetoprotein which is a cancer marker for liver cancer
2.your immediate family members should go for blood tests.
They should get immunised if they are not immune.
If they are carriers too, they should go for regular follow up with the doctor.
3.you should take precautions to prevent the spread of hepatitis B to your family and loved ones
4.you should avoid smoking and drinking alcohol as they may further increase the risk of damage to your liver
5.inform your doctor and dentist that you are a carrier
6.do not donate blood, organs or sperm
7.know the symptoms and signs of the various complications and see your doctor at once if you experience any of them.
What are the Complications of Hepatitis B ?
---------------------------------------------------
Hepatitis B can lead to complications like:
1.acute hepatitis (episode of liver inflammation)
2.chronic hepatitis (permanent liver inflammation)
3.liver cirrhosis (permanent scarring and hardening of the liver)
4.liver failure (liver is unable to function,
resulting in toxins accumulating in body)
5.liver cancer
Those who recover completely from Hepatitis B infection become immune to the disease.
1 in 10 people who get infected with the virus become carriers who then carries the Hepatitis B virus permanently in his body.
Hepatitis B carriers seldom show any symptoms but they can:
1.spread the disease to others
2.develop serious liver complications such as those mentioned above.
About 15%-25% of people with chronic HBV infection die prematurely from these complications.
------------------------------------
What is Hepatitis B?-
-------------------------
Hepatitis B is a serious chronic inflammatory liver disease caused by a virus which is called hepatitis B virus (HBV).
What are the Symptoms of Hepatitis B?
----------------------------------------------
Most of the time a person with HBV infection has no symptoms at all.
Older people are more likely to have symptoms.
If you have symptoms, they might include :
1.jaundice (yellowing of the skin and white of eye)
2.dark coloured urine
3.pale stools
4.prolonged tiredness
5.nausea and vomiting.
6.loss of appetite
7.abdominal pain
8.fever and joint pains
How is the diagnosis of Hepatitis made?
-----------------------------------------------
A blood test is the only way to diagnose hepatitis B.
You may be infected with HBV and may even spread it to others without knowing it.
HBV can be spread from an infected mother to her infant during birth.
To prevent spread of HBV from infected mothers to their infants, every woman should have her blood tested for hepatitis B surface antigen (HBsAg) during each pregnancy.
What is the treatment of Hepatitis B?
-------------------------------------------
There are no medications available for recently acquired (acute) HBV infection. There are antiviral drugs eg interferon which may be able to treat chronic HBV infection.
Who is at risk of getting Hepatitis B?
-------------------------------------------
For those who has never been immunised or do not have antibodies from having a previous Hepatitis B infection, you are at risk of Hepatitis B infection.
The Hepatitis B virus is is not spread through food or water, sharing eating utensils, breastfeeding, hugging, coughing, sneezing, or skin contact.
HBV is spread by exposure to infected blood from skin puncture or contact with mucous membranes.
It is spread by:
1.sexual contact with an infected person
2.an infected mother to her newborn during childbirth
3.a Hepatitis B infected person's blood during blood transfusion
4.sharing of injection needles among drug abusers
5.accidental cuts to the skin by a nail clipper, shaving blade or other instruments that are contaminated with a Hepatitis B infected person's blood
6.contact with an infected person's saliva or blood through cuts or sores in the mouth or skin. Kissing by itself do not spread HBV unless there is a cut in the lips.
7.during acupuncture, body or ear piercing and tattooing if the needles used are contaminated with Hepatitis B infected person's blood
8.have a job that involves contact with human blood or body fluids
What is the best prevention for Hepatitis B?
----------------------------------------------------
Hepatitis B vaccine is the best prevention against hepatitis B.
If you do not have antibodies from a previous infection and if you are not a Hepatitis B carrier, you can get vaccinated against Hepatitis B and protect yourself from its complications.
Hepatitis B vaccine is recommended for all infants, for children and adolescents who were not vaccinated as infants, and for all unvaccinated adults who are at risk for HBV infection as well as any adult who wants to be protected against HBV infection.
The vaccine is safe.
It is also extremely effective provided you complete all 3 doses:
1st dose - at the appointed date
2nd dose - 1 month after the 1st dose
3rd dose - 5 months after the 2nd dose
A booster vaccination may be necessary after 5 years if the blood test showed a drop in immunity.
Infants born to infected mothers need to get hepatitis B vaccine and another shot call HBIG (hepatitis B immune globulin) soon after birth to prevent infection.
Besides vaccination, other ways to prevent transmission of HBV are:
1.avoid multiple sexual partners; keep to one sexual partner
2.Latex condoms, when used consistently and correctly, may reduce the risk of sexually transmitted HBV transmission.
3.Do not inject illegal drugs. Never share needles, syringes or drugs.
4.Do not share personal items like razors, toothbrushes or any other instruments that may cause tears to the skin and hence spread of any blood borne infection.
5.seek reliable operators for ear or body piercing, tattooing or acupuncture.
What happens if I am a Hepatitis B carrier?
--------------------------------------------------
A simple blood test can tell if you are a carrier, are immune or need immunisation.
If you are found to be a carrier, then:
1.you will need to see your doctor every 6 months to a year for tests to check your liver function and blood alpha-foetoprotein which is a cancer marker for liver cancer
2.your immediate family members should go for blood tests.
They should get immunised if they are not immune.
If they are carriers too, they should go for regular follow up with the doctor.
3.you should take precautions to prevent the spread of hepatitis B to your family and loved ones
4.you should avoid smoking and drinking alcohol as they may further increase the risk of damage to your liver
5.inform your doctor and dentist that you are a carrier
6.do not donate blood, organs or sperm
7.know the symptoms and signs of the various complications and see your doctor at once if you experience any of them.
What are the Complications of Hepatitis B ?
---------------------------------------------------
Hepatitis B can lead to complications like:
1.acute hepatitis (episode of liver inflammation)
2.chronic hepatitis (permanent liver inflammation)
3.liver cirrhosis (permanent scarring and hardening of the liver)
4.liver failure (liver is unable to function,
resulting in toxins accumulating in body)
5.liver cancer
Those who recover completely from Hepatitis B infection become immune to the disease.
1 in 10 people who get infected with the virus become carriers who then carries the Hepatitis B virus permanently in his body.
Hepatitis B carriers seldom show any symptoms but they can:
1.spread the disease to others
2.develop serious liver complications such as those mentioned above.
About 15%-25% of people with chronic HBV infection die prematurely from these complications.
Monday, November 5, 2007
A Simple Guide to Hand, Foot & Mouth Disease
A Simple Guide to Hand, Foot and Mouth Disease
----------------------------------------------------------
What is Hand, Foot and Mouth Disease?
-----------------------------------------------
Hand, Foot and Mouth Disease (HFMD) is an infectious disease usually occurring in children which causes ulcers in the mouth and maculopapular rashes(sometimes blisters) on the palms of the hands and soles of the feet.
Because of the locations of the lesions, the illness is thus called Hand, Foot and Mouth Disease.
What causes Hand, Foot and Mouth Disease?
--------------------------------------------------
Hand, Foot and Mouth Disease is caused by the Coxsackie virus and Enterovirus 71.
Of the 2 viruses the enterovirus is more dangerous with some fatalities in severe cases.
Fatalities are usually due to complications involving the heart and nervous system.
It is usually a mild illness with the rash healing in 5 to 7 days.
How is Hand, Foot and Mouth Disease spread?
----------------------------------------------------
HFMD is usually spread through the direct contact with the nasal discharge, saliva, faeces and fluid from the rash of an infected person.
Both adults and children can be affected.
Young children below five years are more prone to the infection.
What are the Symptoms of Hand, Foot and Mouth Disease?
------------------------------------------------------------------
The symptoms usually start after a prodromal peroid of 3 days with:
1.fever
2.sore throat
3.ulcers in the throat, mouth and tongue
4.rash with vesicles (small blisters-- 3-7 mm) on hands, feet and buttock area.
The rash are typically on the palm side of the hands, the sole side of the feet and very characteristic (maculopapular then vesicle) in appearance.
5.loss of appetite
6.headache and bodyaches in the older child or adult
What is the Treatment of Hand, Foot and Mouth Disease?
-------------------------------------------------------------------
There is no specific cure for an viral infection other than symptomatic relief of symptoms.
Antibiotics is not effective and is not indicated.
Paracetamol can given to treat fever.
Drinking lots of water and fluids is important even though sometimes swallowing may be painful.
More fluid is required when a fever is present.
Rinsing of mouth with salt water may soothe the pain of mouth ulcers.
A soft or liquid diet should be given rather than solid food.
Avoid sour fruits or their juices which can cause pain to the mouth ulcers.
Rest and adequate sleep is also important in the child's recovery.
Parents should also be alert to any change in their child's normal behaviour, e.g. irritation and sleepiness.
Should they refuse to eat or drink, have persistent vomiting or drowsiness, parents should bring their child immediately to hospital.
What is the Prevention for Hand, Foot and Mouth Disease?
--------------------------------------------------------------------
All infected children should be kept away from crowded public places (such as schools, preschools, play groups, markets and public transport).
All family members should follow good hygiene practices, including frequent hand washing, to limit the spread of the infection.
A Single Attack usually gives lifelong Immunity!
----------------------------------------------------------
What is Hand, Foot and Mouth Disease?
-----------------------------------------------
Hand, Foot and Mouth Disease (HFMD) is an infectious disease usually occurring in children which causes ulcers in the mouth and maculopapular rashes(sometimes blisters) on the palms of the hands and soles of the feet.
Because of the locations of the lesions, the illness is thus called Hand, Foot and Mouth Disease.
What causes Hand, Foot and Mouth Disease?
--------------------------------------------------
Hand, Foot and Mouth Disease is caused by the Coxsackie virus and Enterovirus 71.
Of the 2 viruses the enterovirus is more dangerous with some fatalities in severe cases.
Fatalities are usually due to complications involving the heart and nervous system.
It is usually a mild illness with the rash healing in 5 to 7 days.
How is Hand, Foot and Mouth Disease spread?
----------------------------------------------------
HFMD is usually spread through the direct contact with the nasal discharge, saliva, faeces and fluid from the rash of an infected person.
Both adults and children can be affected.
Young children below five years are more prone to the infection.
What are the Symptoms of Hand, Foot and Mouth Disease?
------------------------------------------------------------------
The symptoms usually start after a prodromal peroid of 3 days with:
1.fever
2.sore throat
3.ulcers in the throat, mouth and tongue
4.rash with vesicles (small blisters-- 3-7 mm) on hands, feet and buttock area.
The rash are typically on the palm side of the hands, the sole side of the feet and very characteristic (maculopapular then vesicle) in appearance.
5.loss of appetite
6.headache and bodyaches in the older child or adult
What is the Treatment of Hand, Foot and Mouth Disease?
-------------------------------------------------------------------
There is no specific cure for an viral infection other than symptomatic relief of symptoms.
Antibiotics is not effective and is not indicated.
Paracetamol can given to treat fever.
Drinking lots of water and fluids is important even though sometimes swallowing may be painful.
More fluid is required when a fever is present.
Rinsing of mouth with salt water may soothe the pain of mouth ulcers.
A soft or liquid diet should be given rather than solid food.
Avoid sour fruits or their juices which can cause pain to the mouth ulcers.
Rest and adequate sleep is also important in the child's recovery.
Parents should also be alert to any change in their child's normal behaviour, e.g. irritation and sleepiness.
Should they refuse to eat or drink, have persistent vomiting or drowsiness, parents should bring their child immediately to hospital.
What is the Prevention for Hand, Foot and Mouth Disease?
--------------------------------------------------------------------
All infected children should be kept away from crowded public places (such as schools, preschools, play groups, markets and public transport).
All family members should follow good hygiene practices, including frequent hand washing, to limit the spread of the infection.
A Single Attack usually gives lifelong Immunity!
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
Friday, November 2, 2007
A Simple Guide to Depression
A Simple Guide to Depression
-----------------------------------
What is Depression?
------------------------
Depression is a very common mental ilness with an alteration of mood which exceeds normal sadness.
How common is Depression?
----------------------------------
Everyone has felt sad at one time or another.
It may be due to a disappointment, frustration or losing someone.
But time heals, the mood lifts and people continue to get on with their lives.
In some people, depression can be so severe that it dominates their lives, preventing them from living their lives as they used to.
Depression of this degree is a medical illness and needs treatment.
What Are The Types Of Depression?
------------------------------------------
1.Major depression is manifested by a combination of symptoms that affect our work, interests and feelings towards family and friends.
These disabling episodes can occur twice or several times in a lifetime.
2.Dysthymia is a less severe type of depression.
People with dysthymia have long-term depressive symptoms and it prevents them from functioning at an optimal level.
What Are The Causes Of Depression?
--------------------------------------------
1.hereditary or genetic factors in the transmission of depressive disorders.
In some families, major depression seems to occur generation after generation.
2.biological component in depression.
It may be associated with having too little or too much chemicals in the brain.
3. medications have mood altering properties.
Some medication act by altering the biochemical imbalances in the brain causing depression.
4. Life events such as loss of a job, retirement, divorce, death of a loved one or moving to a new house can precipitate a depressive illness.
5.Social circumstances also play a part.
If we are alone, have few or no friends, suffer from a chronic illness, then we may be more vulnerable to depression.
6. People with life threatening or long-term physical illness such as cancer, stroke, arthritis or heart disease are also more vulnerable to depression.
7. Personality may also play a part in depression. Some of us are more vulnerable than others because of the individual make-up or early life experiences.
Very often, a combination of genetic, psychological and environmental factors is involved in the onset of depression.
The good news is that whatever the cause, depression is treatable.
What are the Symptoms Of Depression?
----------------------------------------------
Certain characteristic symptoms can give you or your family a clue that you are depressed:
1.Depressed mood
2.lethargy and fatigue
3.loss of interest and enjoyment in life
4.lack of drive or motivation that makes even simple tasks or decisions difficult or impossible
5.loss of concentration
6.Loss of self confidence, avoiding people
7.Sleeplessness or excessive sleeping
8.Agitation or restlessness
9.ideas of being useless, inadequate, helpless or hopeless
10.Feeling guilty or worthless
11.Loss or gain in appetite, libido with loss or gain in weight
12.Thoughts of suicide;
These symptoms are very common in depression.
It is much better admitted to friends or relatives than to keep them hidden.
How is Depression Treated?
---------------------------------
Reassurance and support is most important in treatment of depression.
Recognition of suicide risk must be remembered when treating a depressed person.
Treatment for depression is well established.
Majority up to 90% of people with major depression have fairly good treatment outcome.
Treatment consists of
drug (antidepressant medication) and
non-drug therapy.
Usually, a combined treatment is best:
1.medication to gain relatively quick relief and
2.psychotherapy to learn more effective ways to deal with life stresses.
Antidepressant Medication
---------------------------------
All antidepressant medications are equally effective but they have different side effects.
The most often used antidepressants include tricyclics, monoamine oxidase inhibitors, lithium and selective serotonin inhibitors (SSRI).
Antidepressant medications do not begin working the day you take them but your mood will improve after one to two weeks.
However, you may notice some improvement on the first day, especially in your sleep and feeling less tense and anxious.
The medications are compatible with painkillers, antibiotics and contraceptives. However, you should avoid alcohol as the medication and alcohol combined can make you too drowsy.
Do not stop the medication once you start to feel better as you may relapse into depression again.
You should discuss this with your doctor and let him advise you when to stop.
Antidepressants like all drugs have some side effects, though these are usually mild and tend to wear off as treatment goes on.
The common side effects and their remedies are:
Dry mouth - drink more water
Constipation - eat more fruits, cereals, prunes and vegetables
Drowsiness - this will pass soon; do not drive or operate heavy machinery if feeling sedated Dizziness - rise from bed or chair slowly
Some side effects with the newer medications:
Headache - this will usually go away
Nausea and stomach discomfort - transient; take medication with food
Nervousness and insomnia - these may occur during the first few weeks, reducing the dose will usually resolve them.
Non Drug Therapy
-----------------------
Psychotherapy
Psychotherapy involves talking things through with a trained counselor or therapist.
Talking to someone who can really listen and understand you without passing judgement can be a tremendous relief.
You learn how to solve problems and cope with life stresses better.
Exercise
Exercise not only improves your health but it also gives you a sense of accomplishment. Endorphins ('feel good' hormones) are released during exercise and this can elevate your mood.
Relaxation Therapy
This involves deep breathing exercises and progressive muscle relaxation.
Support Groups
Support groups offer fellowship and you get to hear first hand accounts of how others with depression, like you, have learnt to cope.
There is also a psychoeducation group which help you learn about the depressive illness and methods of coping.
Electroconvulsive Theraphy (ECT)
ECT is only indicated for those with severe depression who have not responded to treatment or are highly suicidal.
It involves giving a light general anaesthetic and an electric current is passed through the brain for a few seconds. The whole procedure takes only about 15 minutes and the patient is only aware of having gone to sleep.
How Can You Prevent Depression ?
-----------------------------------------
1.try to talk to close friends about bad news
2. Be realistic about your goals. Do not aim too high. Set priorities and do what you can.
3. Do something - get out of the house for a walk or some exercise.
While you may not be able to work, it is always good to try to keep up with some light activities such as housework.
This will help take your mind off those painful feelings.
4. Eat a good balanced diet, even though you may not feel like eating.
5. Resist the temptation to drown your sorrows with alcohol.
Alcohol can depresses the mood, so while it may give you immediate relief by making you forget your problems, this is very temporary and you may end up more depressed.
It is also bad for your liver and general physical health.
6. Remind yourself that you are suffering from depression, something that many other people have gone through, and that you will eventually come out of it, as they do
7.Remember your appointments to see the doctor , take your medicine regularly and do not be afraid to ask for help from your friends and support groups.
-----------------------------------
What is Depression?
------------------------
Depression is a very common mental ilness with an alteration of mood which exceeds normal sadness.
How common is Depression?
----------------------------------
Everyone has felt sad at one time or another.
It may be due to a disappointment, frustration or losing someone.
But time heals, the mood lifts and people continue to get on with their lives.
In some people, depression can be so severe that it dominates their lives, preventing them from living their lives as they used to.
Depression of this degree is a medical illness and needs treatment.
What Are The Types Of Depression?
------------------------------------------
1.Major depression is manifested by a combination of symptoms that affect our work, interests and feelings towards family and friends.
These disabling episodes can occur twice or several times in a lifetime.
2.Dysthymia is a less severe type of depression.
People with dysthymia have long-term depressive symptoms and it prevents them from functioning at an optimal level.
What Are The Causes Of Depression?
--------------------------------------------
1.hereditary or genetic factors in the transmission of depressive disorders.
In some families, major depression seems to occur generation after generation.
2.biological component in depression.
It may be associated with having too little or too much chemicals in the brain.
3. medications have mood altering properties.
Some medication act by altering the biochemical imbalances in the brain causing depression.
4. Life events such as loss of a job, retirement, divorce, death of a loved one or moving to a new house can precipitate a depressive illness.
5.Social circumstances also play a part.
If we are alone, have few or no friends, suffer from a chronic illness, then we may be more vulnerable to depression.
6. People with life threatening or long-term physical illness such as cancer, stroke, arthritis or heart disease are also more vulnerable to depression.
7. Personality may also play a part in depression. Some of us are more vulnerable than others because of the individual make-up or early life experiences.
Very often, a combination of genetic, psychological and environmental factors is involved in the onset of depression.
The good news is that whatever the cause, depression is treatable.
What are the Symptoms Of Depression?
----------------------------------------------
Certain characteristic symptoms can give you or your family a clue that you are depressed:
1.Depressed mood
2.lethargy and fatigue
3.loss of interest and enjoyment in life
4.lack of drive or motivation that makes even simple tasks or decisions difficult or impossible
5.loss of concentration
6.Loss of self confidence, avoiding people
7.Sleeplessness or excessive sleeping
8.Agitation or restlessness
9.ideas of being useless, inadequate, helpless or hopeless
10.Feeling guilty or worthless
11.Loss or gain in appetite, libido with loss or gain in weight
12.Thoughts of suicide;
These symptoms are very common in depression.
It is much better admitted to friends or relatives than to keep them hidden.
How is Depression Treated?
---------------------------------
Reassurance and support is most important in treatment of depression.
Recognition of suicide risk must be remembered when treating a depressed person.
Treatment for depression is well established.
Majority up to 90% of people with major depression have fairly good treatment outcome.
Treatment consists of
drug (antidepressant medication) and
non-drug therapy.
Usually, a combined treatment is best:
1.medication to gain relatively quick relief and
2.psychotherapy to learn more effective ways to deal with life stresses.
Antidepressant Medication
---------------------------------
All antidepressant medications are equally effective but they have different side effects.
The most often used antidepressants include tricyclics, monoamine oxidase inhibitors, lithium and selective serotonin inhibitors (SSRI).
Antidepressant medications do not begin working the day you take them but your mood will improve after one to two weeks.
However, you may notice some improvement on the first day, especially in your sleep and feeling less tense and anxious.
The medications are compatible with painkillers, antibiotics and contraceptives. However, you should avoid alcohol as the medication and alcohol combined can make you too drowsy.
Do not stop the medication once you start to feel better as you may relapse into depression again.
You should discuss this with your doctor and let him advise you when to stop.
Antidepressants like all drugs have some side effects, though these are usually mild and tend to wear off as treatment goes on.
The common side effects and their remedies are:
Dry mouth - drink more water
Constipation - eat more fruits, cereals, prunes and vegetables
Drowsiness - this will pass soon; do not drive or operate heavy machinery if feeling sedated Dizziness - rise from bed or chair slowly
Some side effects with the newer medications:
Headache - this will usually go away
Nausea and stomach discomfort - transient; take medication with food
Nervousness and insomnia - these may occur during the first few weeks, reducing the dose will usually resolve them.
Non Drug Therapy
-----------------------
Psychotherapy
Psychotherapy involves talking things through with a trained counselor or therapist.
Talking to someone who can really listen and understand you without passing judgement can be a tremendous relief.
You learn how to solve problems and cope with life stresses better.
Exercise
Exercise not only improves your health but it also gives you a sense of accomplishment. Endorphins ('feel good' hormones) are released during exercise and this can elevate your mood.
Relaxation Therapy
This involves deep breathing exercises and progressive muscle relaxation.
Support Groups
Support groups offer fellowship and you get to hear first hand accounts of how others with depression, like you, have learnt to cope.
There is also a psychoeducation group which help you learn about the depressive illness and methods of coping.
Electroconvulsive Theraphy (ECT)
ECT is only indicated for those with severe depression who have not responded to treatment or are highly suicidal.
It involves giving a light general anaesthetic and an electric current is passed through the brain for a few seconds. The whole procedure takes only about 15 minutes and the patient is only aware of having gone to sleep.
How Can You Prevent Depression ?
-----------------------------------------
1.try to talk to close friends about bad news
2. Be realistic about your goals. Do not aim too high. Set priorities and do what you can.
3. Do something - get out of the house for a walk or some exercise.
While you may not be able to work, it is always good to try to keep up with some light activities such as housework.
This will help take your mind off those painful feelings.
4. Eat a good balanced diet, even though you may not feel like eating.
5. Resist the temptation to drown your sorrows with alcohol.
Alcohol can depresses the mood, so while it may give you immediate relief by making you forget your problems, this is very temporary and you may end up more depressed.
It is also bad for your liver and general physical health.
6. Remind yourself that you are suffering from depression, something that many other people have gone through, and that you will eventually come out of it, as they do
7.Remember your appointments to see the doctor , take your medicine regularly and do not be afraid to ask for help from your friends and support groups.
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