A Simple Guide to Diabetes Part 2
----------------------------------------
What is the treatment of Diabetes?
-----------------------------------------
Control of Diabetes
-----------------------
Diabetes is a chronic disease which cannot be cured.
It can be controlled to prevent the development of the above serious complications by :
Living a healthy lifestyle
--------------------------
1.diet -
Reduce your intake of sugar and sweet food
Increase intake of more high fibre and wholegrain food like brown rice, wholemeal bread and oats
Take food with less fat content like lean meat, fish, skinless poultry and low fat milk
Have at least 2 servings of vegetables and 2 servings of fruits a day
Use healthier methods of cooking such as grilling and steaming rather than deep frying and use less salt and sauces
Take multiple (4-6) small meals a day that contains enough complex carbohydrates (e.g. rice), some lean meat or fish and vegetables.
Have regular meals and avoid skipping meals
Do not overeat
2.regular exercise-
This helps your body to use glucose more efficiently
Frequency: 3-5 days per week(daily if low intensity)
Intensity: 60-85% of maximum heart rate till the patient feels warm or sweats and breathes deeply but easily
Time: 20-60 mins each time
Type: aerobic exercises like walking, jogging, swimming, cycling
For those who have not been active for some time should start with walking first, then increase to more active exercises
3.weight control -
lose extra body weight by proper dieting and exercise
Aim for half kg loss per week
Aim for a BMI of 18.5-22.9kg/m2
Insulin works better in a lean healthy body.
4.Avoid smoking-
smoking increases all the risks associated with diabetes
5.Avoid stress -
by meditation, yoga, deep breathing exercises
Medication for Diabetes
-----------------------------
1.oral tablets:
a. Insulin secretagogues - drugs that increase insulin release from pancreas
eg. glibenclamide, repaglinide
Side effects: low blood sugar
b.Insulin sensitisers- drugs that make insulin work better especially in muscles and liver
eg.metformin
side effects: gastric discomfort, metallic taste in mouth
eg. rosiglitazone
side effect: water retention
c. Alpha-glucosidase blocker -slows digestion of carbohydrates in the intestine
eg. acarbose
side effect: stomach discomfort, bloating, diarrhea
If the oral medicines even in combination cannot bring down the blood sugar, the insulin injection may be required either alone or together with oral medication.
2.insulin injections
Insulin is destroyed in the stomach so it cannot be taken orally and has to be given as an injection.
Best place to inject the insulin is in the abdominal area where there is a lot of subcutaneous fat.
Avoid 2 fingers around the navel and below the rib cage where there is a rich nerve supply and therefore more painful.
Injection is usually done in the morning and evening.
Night injection controls the glucose when the patient sleep and avoid early morning high glucose.
a.Rapid and short acting insulin
eg. regular soluble insulin
onset 30-60min, peak 2-4 hrs, duration 6-8 hrs
b.intermediate and long acting insulin
eg. NPH insulin
onset 1-4 hrs, peak 8-12 hrs, duration 12-20hr
c.premixed or biphasic insulin
eg. NPH/regular 70/30
more convenient and less injections
Important hygience tips:
Use needles once only
Mix well by shaking bottle or injection pen 20 times
Store all unused insulin in fridge(will keep until expiry date).
Do not freeze insulin.
Insulin in use can be kept at room temprature away from sunlight and direct heat and must be discarded 4-6 weeks after use
Follow the instructions very carefully and keep detailed records of your treatment.
Home blood glucose monitoring
--------------------------------------
1. monitor your progress with the help of your daily home blood glucose records.
Monitor;
a. before and after meals
b. before and after exercise
c. when feeling giddy to confirm low blood glucose
d. when sick and not eating well
Type 1 diabetes should be monitored 3-4 times a day
Type 2 non-insulin diabetes 1-2 times a day followed by 1 every 2-3 days
Type 2 insulin diabetes 2-3 times a day followed by 2-3 days a week.
Pregnant diabetic patient should also monitor their blood glucose daily
Aim for a Fasting Blood glucose 4.0 -7.0mmol/l
Blood HbA1c 4.5 -7.0
This will check if your diabetes is under control.
If not, you need more medicines or further change in diet.
High blood pressure and high blood cholesterol level
---------------------------------------------------------------
Reducing high blood pressure and high cholesterol level help to keep diabetes under control and protect against its complications.
Aim for a blood pressure of 130/80 or less
LDL cholesterol of 2.6mmol/l
Regular checkups is important in the treatment of Diabetes
-----------------------------------------------------------------------
1. Regular monthly checkups for diabetes until fully controlled, bimonthly after that.
2. Check for hypertension and heart disease at the same time
3. Check for high blood cholesterol once a year.
4. Check eyes once a year.
5. Check for kidney problems at least once a year.
6. Check teeth once a year
7. Check you feet for signs of infection, gangrene and neuropathy.
Foot care:
-------------
1. wash feet daily with soap and water
2. After washing ,dry thoroughly especially betwwen the toes
3. keep yor toe nails short,trimming them straight across to avoid ingrowing toenails
4. moisturise feet daily to prevent dryness and cracking of skin
5. examine feet daily for scratches, cuts, blisters and corn
6. use a mirror to check the sole of your feet
7. wear shoes that fit well and wear clean cotton socks which has loose fitting elastic tops
8.Avoid going barefoot
9.Seek prompt treatment for cuts and sores
10.annual review for foot ulcers,risk of neuropathy(poor sensation), blood circiulation( palpable pulses)
Health education
---------------------
It is important to increase your knowledge of diabetes and its complications.
With knowledge, diabetes can be more easily controlled.
A well controlled diabetic patient can live a normal life.
Tuesday, December 11, 2007
Monday, December 10, 2007
A Simple Guide to Diabetes Mellitus
A Simple Guide to Diabetes Mellitus
-------------------------------------------
What is Diabetes?
---------------------
Diabetes mellitus literally means sweet urine.
It is a common chronic disease which happens when the hormone insulin produced by the pancreas is missing, lacking or not working well.
Insulin unlocks the cell to allow glucose from the bloodstream to enter the body cells for usage or storage.
When this mechanism fail, the high amount of glucose in the blood leads to the glucose being spilt over into the urine, causing diabetes.
What are the different types of diabetes?
-----------------------------------------
The main types of diabetes are
1.Type 1
2.Type 2.
Type 1 occurs commonly in children and young adults although it may occur at any age.
It is more serious because there is practically no insulin produced due to damaged pancreatic cells and therefore insulin injections is needed for treatment.
The cause is unknown.
Complications are more sudden and life-threatening.
Type 2 is more common.
It is found in
1.adults over 40 years old,
2.overweight and
3.physically inactive.
The insulin produced is not enough or may not be working effectively.
Type 2 diabetes can be controlled by proper dieting and exercise.
Most Type 2 diabetics will also need oral medication.
Gestational diabetes occurs only in pregnancy but may be an indicator of diabetes later in life
What are the risk factors for diabetes?
----------------------------------------------
Diabetes is more likely to occur if you have:
1.Obesity (body mass index > 23)
2.family history of diabetes
3.hypertension (>140/90 mmHg)
4.previous gestational diabetes
5.Coronary heart disease
6.polycystic ovary disease
7.Hyperlipidemia(high blood cholesterol >5.2 mmol or 220mg/dl and
tryglycerides >2.30)
8.Inadequate regular exercise
9.age above 40 years,more common in males than females
10.smoking habit
What are the Signs and Symptoms of Diabetes?
-------------------------------------------------------
The following symptoms are typical of diabetes:
1.frequent thirst even after drinking lots of water
2.passing more frequent urine during day and night
3.weight loss while having good appetite
4.constant tiredness
5.poor healing of skin wounds
6.itchy skin particularly around the genital area
7.constant hunger
8.blurred vision
Note that some diabetics may not experience any symptoms at all.
How do you made the diagnosis of Diabetes?
----------------------------------------------------
Blood glucose test:
1.Random blood glucose (anytime) is 11.1mmol/l or higher
2.Fasting blood glucose (after 8 hours of overnight fast) is 7.0mmol/l or higher.
3.Oral 75g Glucose Tolerance Test show presence of diabetes
How does diabetes cause complications in the body?
--------------------------------------------------------------
The high blood glucose concentration in diabetes reduces the blood flow to many organs and nerves resulting in many organ damage especially the kidney, heart, brain, eyes and nerves.
The high blood glucose allows germs to proliferate because the glucose provides nutrition to the germs.
All these lead to many serious complications:
1.high blood pressure,
2.heart attack,
3.stroke,
4.kidney failure,
5.blindness,
6.impotence,
7.numbness of hands and feet,
8.infections with poor healing,
9.wounds on feet that do not heal
10.coma,
Treatment of Diabetes will dealt with in the Part 2.
-------------------------------------------
What is Diabetes?
---------------------
Diabetes mellitus literally means sweet urine.
It is a common chronic disease which happens when the hormone insulin produced by the pancreas is missing, lacking or not working well.
Insulin unlocks the cell to allow glucose from the bloodstream to enter the body cells for usage or storage.
When this mechanism fail, the high amount of glucose in the blood leads to the glucose being spilt over into the urine, causing diabetes.
What are the different types of diabetes?
-----------------------------------------
The main types of diabetes are
1.Type 1
2.Type 2.
Type 1 occurs commonly in children and young adults although it may occur at any age.
It is more serious because there is practically no insulin produced due to damaged pancreatic cells and therefore insulin injections is needed for treatment.
The cause is unknown.
Complications are more sudden and life-threatening.
Type 2 is more common.
It is found in
1.adults over 40 years old,
2.overweight and
3.physically inactive.
The insulin produced is not enough or may not be working effectively.
Type 2 diabetes can be controlled by proper dieting and exercise.
Most Type 2 diabetics will also need oral medication.
Gestational diabetes occurs only in pregnancy but may be an indicator of diabetes later in life
What are the risk factors for diabetes?
----------------------------------------------
Diabetes is more likely to occur if you have:
1.Obesity (body mass index > 23)
2.family history of diabetes
3.hypertension (>140/90 mmHg)
4.previous gestational diabetes
5.Coronary heart disease
6.polycystic ovary disease
7.Hyperlipidemia(high blood cholesterol >5.2 mmol or 220mg/dl and
tryglycerides >2.30)
8.Inadequate regular exercise
9.age above 40 years,more common in males than females
10.smoking habit
What are the Signs and Symptoms of Diabetes?
-------------------------------------------------------
The following symptoms are typical of diabetes:
1.frequent thirst even after drinking lots of water
2.passing more frequent urine during day and night
3.weight loss while having good appetite
4.constant tiredness
5.poor healing of skin wounds
6.itchy skin particularly around the genital area
7.constant hunger
8.blurred vision
Note that some diabetics may not experience any symptoms at all.
How do you made the diagnosis of Diabetes?
----------------------------------------------------
Blood glucose test:
1.Random blood glucose (anytime) is 11.1mmol/l or higher
2.Fasting blood glucose (after 8 hours of overnight fast) is 7.0mmol/l or higher.
3.Oral 75g Glucose Tolerance Test show presence of diabetes
How does diabetes cause complications in the body?
--------------------------------------------------------------
The high blood glucose concentration in diabetes reduces the blood flow to many organs and nerves resulting in many organ damage especially the kidney, heart, brain, eyes and nerves.
The high blood glucose allows germs to proliferate because the glucose provides nutrition to the germs.
All these lead to many serious complications:
1.high blood pressure,
2.heart attack,
3.stroke,
4.kidney failure,
5.blindness,
6.impotence,
7.numbness of hands and feet,
8.infections with poor healing,
9.wounds on feet that do not heal
10.coma,
Treatment of Diabetes will dealt with in the Part 2.
Saturday, December 8, 2007
A Simple Guide to Beestings
A Simple Guide to Beestings
----------------------------------
What are beestings?
--------------------------
Beestings include stings by different bees, wasps and hornets.
The most common sting is by the common honeybee.
Usually the bee stings the patient skin, leaving its stinger behind and dies.
What are the symptoms of Beestings?
-------------------------------------------
1. stinger left on the skin
2. pain and mild discomfort may last a few hours
3. swelling of the skin at the sting site in sensitive patients reacting to the venom of the sting
4. itch at the site may lasts for a week
The main component of bee venom responsible for pain is the toxin melittin.
Histamine and amines in the beesting contribute to the pain and itching.
Most beesting are acidic in nature.
What is the treatment of Beestings?
------------------------------------------
1.Remove the barbed stinger.
2.Apply cold compress to reduce pain and swelling.
3.Use baking soda solution to conteract the acid.
4.Give paracetamol and antihistmines for pain and itch
For more severe reactions such as allergy and anaphylactic shock to the beestings, emergency treatment may be required:
1.Give adrenaline injection subcutaneously slowly over a minute peroid
followed by
2.antihistamine like diphenhydramine intravenously
3.Treat shock
4.Corticosteroids may be needed to counter allergy
Multiple beestings may cause severe reaction with shock and hemaglobinuria.
This may require hospitalisation.
Multiple beestings have been known to cause the kidneys and vital organs to shut down and should be treated urgently.
----------------------------------
What are beestings?
--------------------------
Beestings include stings by different bees, wasps and hornets.
The most common sting is by the common honeybee.
Usually the bee stings the patient skin, leaving its stinger behind and dies.
What are the symptoms of Beestings?
-------------------------------------------
1. stinger left on the skin
2. pain and mild discomfort may last a few hours
3. swelling of the skin at the sting site in sensitive patients reacting to the venom of the sting
4. itch at the site may lasts for a week
The main component of bee venom responsible for pain is the toxin melittin.
Histamine and amines in the beesting contribute to the pain and itching.
Most beesting are acidic in nature.
What is the treatment of Beestings?
------------------------------------------
1.Remove the barbed stinger.
2.Apply cold compress to reduce pain and swelling.
3.Use baking soda solution to conteract the acid.
4.Give paracetamol and antihistmines for pain and itch
For more severe reactions such as allergy and anaphylactic shock to the beestings, emergency treatment may be required:
1.Give adrenaline injection subcutaneously slowly over a minute peroid
followed by
2.antihistamine like diphenhydramine intravenously
3.Treat shock
4.Corticosteroids may be needed to counter allergy
Multiple beestings may cause severe reaction with shock and hemaglobinuria.
This may require hospitalisation.
Multiple beestings have been known to cause the kidneys and vital organs to shut down and should be treated urgently.
Friday, December 7, 2007
A Simple Guide to AIDS
A Simple Guide to AIDS
----------------------------
What is AIDS?
------------------
AIDS is an acronym for Acquired Immune Deficiency Syndrome which is the final and most serious stage of HIV.
HIV stands for the Human Immunodeficiency Virus which can dause a person infected with it up to 10 years to develop AIDS.
There are actually 2 types of HIV virus:
HIV-1 is the source of the majority of HIV infections throughout the world.
HIV-2 is not as easily transmitted and is mainly found in West Africa.
How is HIV transmitted?
------------------------------
HIV is transmitted by:
1.unprotected sexual intercourse with an infected person(semen,vaginal fluid)
2.the usage of HIV-tainted needles
3.from a mother to her baby during pregnancy and birth, also during breastfeeding
4.receiving infected blood and blood products
What is the danger of HIV?
-------------------------------
The HIV infection destroys CD4 (T-cell) lymphocytes and thus weakens the body's immune defences.
The T-cells are white blood cells which helps to protect the body from bacteria, viruses, fungi and parasites.
If the T-cells are destroyed or weakened, they are less able to defend the body effectively against infections.
Having HIV also increases the risk of getting cancers.
The HIV virus can attack every organ of the body.
AIDS which is the terminal stage of HIV infection is fatal.
Once you reach this stage, the person usually dies 1-3 years from various infections and cancers.
What are the symptoms of HIV?
--------------------------------------
Usually, a HIV-infected person may not notice any symptoms.
However, the following symptoms may be experienced subsequently:
1.fever,chills
2.Loss of weight
2.sore throat
3.muscular stiffness or aches
4.headache
5.diarrhoea
6.swollen lymph glands
7.fatigue
8.rash of various types
9.joint pain
WHO Classification Of HIV:
---------------------------------
Stage I: HIV infection is asymptomatic and not categorized as AIDS
Stage II: includes minor mucocutaneous manifestations and recurrent upper respiratory tract infections
Stage III: includes unexplained chronic diarrhea for longer than a month, severe bacterial infections and pulmonary tuberculosis
Stage IV: includes toxoplasmosis of the brain, candidiasis of the esophagus, trachea, bronchi or lungs and Kaposi's sarcoma;
these diseases are indicators of AIDS.
How do you test for HIV?
-----------------------------
Blood test for HIV Antibodies.
A negative result does not necessary mean you do not have HIV.
There is a window period of 3-6 months sometimes before the HIV antibodies show positive results.
When a test shows positive results, the blood is retested at a CDC(Communicable Disease Centre) which is able to test more specific tests for HIV.(Western Blot HIV Confirmatory Test)
Rapid HIV testing throgh oral swabs is now offered in some medical clinics.
These tests produce very quick results.
In approximately 20 minutes you may be able to know your HIV status.
New tests for HIV includes HIV-DNA and HIV-RNA testing.
Is there a cure for HIV or AIDS?
-------------------------------------
At the present moment there is no cure for HIV or AIDS.
Treatments which can improve the patient’s immune system and prevent the onset of AIDS however are available:
1.Reverse transcriptase (RT) inhibitors:
This first group of drugs approved to treat HIV infection act by preventing the replication of the HIV virus.
The HIV virus is unable to spread in the body so easily and less secondary infection may attack the body.
2.Protease inhibitors:
This second class of drugs act by stopping the replication of HIV at a later stage in the cycle.
3.Combination or cocktail therapy (using two or more drugs together) is preferred in case the HIV virus becomes resistant to both classes of drugs.
4. Some new methods involve the use of thalidomide, antimalarial and Anti-TB drugs
THE ABC method of prevention:
------------------------------------
Abstinence or delay of sexual activity, especially for youth,
Being faithful, especially for those in committed relationships,
Condom use, for those who engage in risky behavior.
The CNN method of prevention:
-------------------------------------
Condom use, for those who engage in risky behavior,
Needles, use clean ones,
Negotiating safer sex with a partner and empowering women to make smart choices
World AIDS day is on 1st December every year.
----------------------------
What is AIDS?
------------------
AIDS is an acronym for Acquired Immune Deficiency Syndrome which is the final and most serious stage of HIV.
HIV stands for the Human Immunodeficiency Virus which can dause a person infected with it up to 10 years to develop AIDS.
There are actually 2 types of HIV virus:
HIV-1 is the source of the majority of HIV infections throughout the world.
HIV-2 is not as easily transmitted and is mainly found in West Africa.
How is HIV transmitted?
------------------------------
HIV is transmitted by:
1.unprotected sexual intercourse with an infected person(semen,vaginal fluid)
2.the usage of HIV-tainted needles
3.from a mother to her baby during pregnancy and birth, also during breastfeeding
4.receiving infected blood and blood products
What is the danger of HIV?
-------------------------------
The HIV infection destroys CD4 (T-cell) lymphocytes and thus weakens the body's immune defences.
The T-cells are white blood cells which helps to protect the body from bacteria, viruses, fungi and parasites.
If the T-cells are destroyed or weakened, they are less able to defend the body effectively against infections.
Having HIV also increases the risk of getting cancers.
The HIV virus can attack every organ of the body.
AIDS which is the terminal stage of HIV infection is fatal.
Once you reach this stage, the person usually dies 1-3 years from various infections and cancers.
What are the symptoms of HIV?
--------------------------------------
Usually, a HIV-infected person may not notice any symptoms.
However, the following symptoms may be experienced subsequently:
1.fever,chills
2.Loss of weight
2.sore throat
3.muscular stiffness or aches
4.headache
5.diarrhoea
6.swollen lymph glands
7.fatigue
8.rash of various types
9.joint pain
WHO Classification Of HIV:
---------------------------------
Stage I: HIV infection is asymptomatic and not categorized as AIDS
Stage II: includes minor mucocutaneous manifestations and recurrent upper respiratory tract infections
Stage III: includes unexplained chronic diarrhea for longer than a month, severe bacterial infections and pulmonary tuberculosis
Stage IV: includes toxoplasmosis of the brain, candidiasis of the esophagus, trachea, bronchi or lungs and Kaposi's sarcoma;
these diseases are indicators of AIDS.
How do you test for HIV?
-----------------------------
Blood test for HIV Antibodies.
A negative result does not necessary mean you do not have HIV.
There is a window period of 3-6 months sometimes before the HIV antibodies show positive results.
When a test shows positive results, the blood is retested at a CDC(Communicable Disease Centre) which is able to test more specific tests for HIV.(Western Blot HIV Confirmatory Test)
Rapid HIV testing throgh oral swabs is now offered in some medical clinics.
These tests produce very quick results.
In approximately 20 minutes you may be able to know your HIV status.
New tests for HIV includes HIV-DNA and HIV-RNA testing.
Is there a cure for HIV or AIDS?
-------------------------------------
At the present moment there is no cure for HIV or AIDS.
Treatments which can improve the patient’s immune system and prevent the onset of AIDS however are available:
1.Reverse transcriptase (RT) inhibitors:
This first group of drugs approved to treat HIV infection act by preventing the replication of the HIV virus.
The HIV virus is unable to spread in the body so easily and less secondary infection may attack the body.
2.Protease inhibitors:
This second class of drugs act by stopping the replication of HIV at a later stage in the cycle.
3.Combination or cocktail therapy (using two or more drugs together) is preferred in case the HIV virus becomes resistant to both classes of drugs.
4. Some new methods involve the use of thalidomide, antimalarial and Anti-TB drugs
5. A cure For HIV will be to produce a vaccine against the HIV virus.
How can I protect myself from HIV infection?
-----------------------------------------------------
THE ABC method of prevention:
------------------------------------
Abstinence or delay of sexual activity, especially for youth,
Being faithful, especially for those in committed relationships,
Condom use, for those who engage in risky behavior.
The CNN method of prevention:
-------------------------------------
Condom use, for those who engage in risky behavior,
Needles, use clean ones,
Negotiating safer sex with a partner and empowering women to make smart choices
World AIDS day is on 1st December every year.
Thursday, December 6, 2007
A Simple guide to Diphtheria
A Simple guide to Diphtheria
------------------------------------
What is Diphtheria?
-----------------------
Diphtheria is an acute, infectious childhood disease of the respiratory tract caused by the bacillus Corynebacterium diphtheriae, a Gram positive, non-sporulating aerobic micro-organism.
How is Diphtheria transmitted?
--------------------------------------
Diphtheria is transmitted by droplets from the throat of infected patients or clothes soiled by discharges from the patients.
It is highly infectious.
Incubation period is 2-4 days.
The organism multiplies in the upper respiratory tract, secreting toxins which produce necrosis and fibrinous exudate.
This fibrinous exudate can form a leathery membrane which extends through the throat, tonsils, nasopharynx, larynx and trachea.
Through the blood, the toxin can spreadto the heart, nervous system and kidneys. Infections may also be localised in wounds in the skin,conjunctiva and rarely the vagina.
The infections occur in persons of all ages.
What are the Signs and Symptoms of Diphtheria?
----------------------------------------------------------
The incubation peroid is usually 2-4 days after contact with an infected patient.
Symptoms start off with:
1. sudden onset of malaise
2. mild fever
3. sore throat
4. Thick white or grayish tonsillar exudate
5. Membrane may spread to nasopharynx
5. cervical lymphadenopathy
6. difficult breathing
7. respiratory stridor,
8. hoarseness of voice
9. brassy cough
10.dilirium and coma
What are the complications of Diphtheria?
---------------------------------------------------
The worst affected are children below the 1 year old.
Some serious complications are:
1.myocarditis
2.cranial nerve paralysis, especially the soft palate and oculomotor nerves
3.peripheral neuritis
4.laryngeal obstruction
5.death can occur if there is obstruction to breathing.
Serious complications are less with older children or adults.
Adults rarely get Diphtheria because their immunity from vaccination usually last 10 years after the last dose.
When adults get Diphtheria, there is only slight inflammation with little or no exudates.
What are the investigations necessary to diagnose Diphtheria?
--------------------------------------------------------------------------
Pharyngeal and nasal swabs for culture in Loeffler medium
Methylene blue stain of membrane
What is the Treatment of Diphtheria?
--------------------------------------------
Isolation in hospital is necessary.
1.Antibiotics (erythromycin or Penicillin) are used in the treatment of Diphtheria.
2.Antitoxin can be given by intramuscular or intravenous injection
3.Intravenous fluids given for dehydration
4.Tracheostomy if breathing obstruction is bad
5.Oxygen therapy in cases of breathing difficulty
6.Cardiac failure should be treated
Besides antibiotics, the following will help:
Steam inhalation
cough mixtures
avoid smokes, dust, dry air,sudden temperature change
What is the Prevention for Diphtheria?
-------------------------------------------------
Vaccination against Diphtheria is the best prevention .
Since vaccination began, the worldwide incidence of Diphtheria has declined.
Vaccination against diphtheria, pertussis (whooping cough), tetanus (DPT) is usually given to a baby at 3 months of age and repeated at 4 and 5 months of age.
There is also a booster vaccination at 18 months.
What is the prognosis in Diphtheria?
-------------------------------------------
Death occurs in 10% of cases.
Mortality is highest in children under 10 and adults over 50.
One attack usually confers immunity.
------------------------------------
What is Diphtheria?
-----------------------
Diphtheria is an acute, infectious childhood disease of the respiratory tract caused by the bacillus Corynebacterium diphtheriae, a Gram positive, non-sporulating aerobic micro-organism.
How is Diphtheria transmitted?
--------------------------------------
Diphtheria is transmitted by droplets from the throat of infected patients or clothes soiled by discharges from the patients.
It is highly infectious.
Incubation period is 2-4 days.
The organism multiplies in the upper respiratory tract, secreting toxins which produce necrosis and fibrinous exudate.
This fibrinous exudate can form a leathery membrane which extends through the throat, tonsils, nasopharynx, larynx and trachea.
Through the blood, the toxin can spreadto the heart, nervous system and kidneys. Infections may also be localised in wounds in the skin,conjunctiva and rarely the vagina.
The infections occur in persons of all ages.
What are the Signs and Symptoms of Diphtheria?
----------------------------------------------------------
The incubation peroid is usually 2-4 days after contact with an infected patient.
Symptoms start off with:
1. sudden onset of malaise
2. mild fever
3. sore throat
4. Thick white or grayish tonsillar exudate
5. Membrane may spread to nasopharynx
5. cervical lymphadenopathy
6. difficult breathing
7. respiratory stridor,
8. hoarseness of voice
9. brassy cough
10.dilirium and coma
What are the complications of Diphtheria?
---------------------------------------------------
The worst affected are children below the 1 year old.
Some serious complications are:
1.myocarditis
2.cranial nerve paralysis, especially the soft palate and oculomotor nerves
3.peripheral neuritis
4.laryngeal obstruction
5.death can occur if there is obstruction to breathing.
Serious complications are less with older children or adults.
Adults rarely get Diphtheria because their immunity from vaccination usually last 10 years after the last dose.
When adults get Diphtheria, there is only slight inflammation with little or no exudates.
What are the investigations necessary to diagnose Diphtheria?
--------------------------------------------------------------------------
Pharyngeal and nasal swabs for culture in Loeffler medium
Methylene blue stain of membrane
What is the Treatment of Diphtheria?
--------------------------------------------
Isolation in hospital is necessary.
1.Antibiotics (erythromycin or Penicillin) are used in the treatment of Diphtheria.
2.Antitoxin can be given by intramuscular or intravenous injection
3.Intravenous fluids given for dehydration
4.Tracheostomy if breathing obstruction is bad
5.Oxygen therapy in cases of breathing difficulty
6.Cardiac failure should be treated
Besides antibiotics, the following will help:
Steam inhalation
cough mixtures
avoid smokes, dust, dry air,sudden temperature change
What is the Prevention for Diphtheria?
-------------------------------------------------
Vaccination against Diphtheria is the best prevention .
Since vaccination began, the worldwide incidence of Diphtheria has declined.
Vaccination against diphtheria, pertussis (whooping cough), tetanus (DPT) is usually given to a baby at 3 months of age and repeated at 4 and 5 months of age.
There is also a booster vaccination at 18 months.
What is the prognosis in Diphtheria?
-------------------------------------------
Death occurs in 10% of cases.
Mortality is highest in children under 10 and adults over 50.
One attack usually confers immunity.
Wednesday, December 5, 2007
A Simple Guide to Hiccups
A Simple Guide to Hiccups
-------------------------------
What is Hiccups?
---------------------
Hiccups is a symptom, not an illness.
It is the sound produced in the throat when the epiglottis flip backwards during a sudden involuntary contraction of the diaphragm
What are the causes of Hiccups?
--------------------------------------
Hiccups is initiated when a sudden involuntary movement of the diaphragm( the large muscle separating the chest from the abdomen)causes a sudden drop in air pressure in the lung.
Air rushes in through the mouth to enter the lungs.
As it rushes in , it causes the epiglottis(the valve that closes the windpipe during swallowing or drinking) to flip backwards causing the hiccup sound.
Hiccups may occur when :
1.a full stomach pressing against the nerve to the diaphragm causing an involuntary contraction of the diaphragm
2.hasty swallowing of food or air which distends the stomach and causes it to press against the nerve to the diaphragm.
3.unexplained unregulated nervous activity of the diaphragm
Most hiccups are harmless and last for a few hours to 1 day.
Some hiccups have known to last for years.
What are the treatment of Hiccups?
-------------------------------------------
1.holding the breath as long as possible and repeating it several times.
Holding the breath may prevent air from rushing into the lungs through the epiglottis.
2.breathing into a paper bag until the hiccup stop (usually within 3 minutes).
Breathing into a paper bag cause accumulation of carbon dioxide in the air in the bag.
The increased level of carbon dioxide in the blood may slow down activity of the part of the brain controlling the diaphragm hence causing the hiccup to stop.
3.Drinking a whole glass of water without stopping at one time.
This has the same effect as holding the breath because you cannot drink and breathe at the same time.
4.Taking medications such as an anti-epileptic or anti-spasmodic may be able to stop the hiccups by stopping the contraction of the diaphragm.
-------------------------------
What is Hiccups?
---------------------
Hiccups is a symptom, not an illness.
It is the sound produced in the throat when the epiglottis flip backwards during a sudden involuntary contraction of the diaphragm
What are the causes of Hiccups?
--------------------------------------
Hiccups is initiated when a sudden involuntary movement of the diaphragm( the large muscle separating the chest from the abdomen)causes a sudden drop in air pressure in the lung.
Air rushes in through the mouth to enter the lungs.
As it rushes in , it causes the epiglottis(the valve that closes the windpipe during swallowing or drinking) to flip backwards causing the hiccup sound.
Hiccups may occur when :
1.a full stomach pressing against the nerve to the diaphragm causing an involuntary contraction of the diaphragm
2.hasty swallowing of food or air which distends the stomach and causes it to press against the nerve to the diaphragm.
3.unexplained unregulated nervous activity of the diaphragm
Most hiccups are harmless and last for a few hours to 1 day.
Some hiccups have known to last for years.
What are the treatment of Hiccups?
-------------------------------------------
1.holding the breath as long as possible and repeating it several times.
Holding the breath may prevent air from rushing into the lungs through the epiglottis.
2.breathing into a paper bag until the hiccup stop (usually within 3 minutes).
Breathing into a paper bag cause accumulation of carbon dioxide in the air in the bag.
The increased level of carbon dioxide in the blood may slow down activity of the part of the brain controlling the diaphragm hence causing the hiccup to stop.
3.Drinking a whole glass of water without stopping at one time.
This has the same effect as holding the breath because you cannot drink and breathe at the same time.
4.Taking medications such as an anti-epileptic or anti-spasmodic may be able to stop the hiccups by stopping the contraction of the diaphragm.
A Simple Guide to Typhoid Fever
A Simple Guide to Typhoid Fever
---------------------------------------
What is Typhoid Fever?
---------------------------
Typhoid Fever is an acute febrile illness caused by the Salmonella typhi bacteria.
What is the cause of Typhoid Fever?
-------------------------------------------
The bacteria which causes Typhoid Fever is the Salmonella typhi which is an extremely hardy bacteria able to live in polluted water, contaminated food and soiled clothes.
Oral ingestion of the bacteria leads to penetration of the small bowel mucosa and rapid spread to lymphatics, lymph nodes and blood stream.
Once it entered the bloodstream, fever occur.
It then enters the spleen, liver and gallbladder and penetrates into the mucosa of the rest of the intestine, causing thinning of the walls of the bowels.
Incubation period is 5-10 days.
What are symptoms of Typhoid Fever?
----------------------------------------------
The main symptoms of Typhoid Fever are
1. Fever which becomes higher and higher like a step ladder
2. headache
3. abdominal pain
4. green pea soup type of diarrhea
5. enlarged spleen and liver
6. delirium and disorientation from high fever and dehydration
7. lassitude and tiredness
8. rose spots rash on the body
Symptoms usually appear within 5-10 days after exposure to the germ and last for 3-4 weeks.
How is Typhoid Fever transmitted?
------------------------------------------
Typhoid Fever can be highly contagious.
The germs are commonly transmitted by food handlers who are typhoid carriers.
People can get the germs from contaminated food and drinks.
How is the diagnosis of Typhoid Fever made?
-----------------------------------------------------
Doctors generally diagnose Typhoid Fever based on the symptoms and a physical examination.
Confirmation is by blood tests(Widal test), blood and stool cultures.
What are the complications of Typhoid Fever?
-------------------------------------------------------
Typhoid Fever is a disease which can kill especially through its complications:
1.Intestinal hemorrhage
2.Intestinal perforation
3.Cholecystitis
4.dehydration especially in young children and the very old patients
How is Typhoid Fever treated?
-------------------------------------
Thypoid is an infectious disease which can spread to other people through soiled clothes, contaminated food.
It is therefore advisable to quarantine the patient in hospitals.
Antibiotics is the main treatment against typhoid.
The best antibiotic is chloramphenicol but because of its side effects of aplastic anemia it should be avoided especially in pregnant women and young children.
Other antibiotics used are septrin(co-timoxazole) and ampicillin.
Antibiotics should be continued for at least 2 weeks.
Symptomatic treatment includes:
1.Paracetamol for relief of fever and headache
Aspirin is to be avoided to prevent intestinal bleeding.
2.antispasmodic drug to stop abdominal cramps
3.medicine to harden the stools such as kaolin
4.slow down the intestinal movement (lomotil or loperamide).
Prompt treatment may be needed to prevent dehydration:
Dehydration can be caused by diarrhea, excessive sweating from the high fever, or by not drinking enough fluids because of loss of appetite.
Mild dehydration can be treated by drinking liquids.
Severe dehydration may require intravenous fluids.
Untreated severe dehydration can be life threatening especially in babies, young children and the elderly.
Gradually reintroduce food, starting with bland, easy-to-digest food, like porridge or soups.
Get plenty of rest.
Complications such as intestinal perforation may require surgical treatment.
How is Typhoid Fever prevented?
----------------------------------------
Prevention of typhoid is usually by vaccination of all food handlers and staff working in restaurants.
Food handlers should always wash their hands after going to the toilets and before cooking food.
They should always wear gloves when handling or cooking food.
Treatment of chronic typhoid carriers with antibiotics such as ampicillin for 6 months and removal of gallbladder which may harboured the bacteria.
You can avoid infection by:
Avoid eating or drinking foods or liquids that might be contaminated
Good food hygience
---------------------------------------
What is Typhoid Fever?
---------------------------
Typhoid Fever is an acute febrile illness caused by the Salmonella typhi bacteria.
What is the cause of Typhoid Fever?
-------------------------------------------
The bacteria which causes Typhoid Fever is the Salmonella typhi which is an extremely hardy bacteria able to live in polluted water, contaminated food and soiled clothes.
Oral ingestion of the bacteria leads to penetration of the small bowel mucosa and rapid spread to lymphatics, lymph nodes and blood stream.
Once it entered the bloodstream, fever occur.
It then enters the spleen, liver and gallbladder and penetrates into the mucosa of the rest of the intestine, causing thinning of the walls of the bowels.
Incubation period is 5-10 days.
What are symptoms of Typhoid Fever?
----------------------------------------------
The main symptoms of Typhoid Fever are
1. Fever which becomes higher and higher like a step ladder
2. headache
3. abdominal pain
4. green pea soup type of diarrhea
5. enlarged spleen and liver
6. delirium and disorientation from high fever and dehydration
7. lassitude and tiredness
8. rose spots rash on the body
Symptoms usually appear within 5-10 days after exposure to the germ and last for 3-4 weeks.
How is Typhoid Fever transmitted?
------------------------------------------
Typhoid Fever can be highly contagious.
The germs are commonly transmitted by food handlers who are typhoid carriers.
People can get the germs from contaminated food and drinks.
How is the diagnosis of Typhoid Fever made?
-----------------------------------------------------
Doctors generally diagnose Typhoid Fever based on the symptoms and a physical examination.
Confirmation is by blood tests(Widal test), blood and stool cultures.
What are the complications of Typhoid Fever?
-------------------------------------------------------
Typhoid Fever is a disease which can kill especially through its complications:
1.Intestinal hemorrhage
2.Intestinal perforation
3.Cholecystitis
4.dehydration especially in young children and the very old patients
How is Typhoid Fever treated?
-------------------------------------
Thypoid is an infectious disease which can spread to other people through soiled clothes, contaminated food.
It is therefore advisable to quarantine the patient in hospitals.
Antibiotics is the main treatment against typhoid.
The best antibiotic is chloramphenicol but because of its side effects of aplastic anemia it should be avoided especially in pregnant women and young children.
Other antibiotics used are septrin(co-timoxazole) and ampicillin.
Antibiotics should be continued for at least 2 weeks.
Symptomatic treatment includes:
1.Paracetamol for relief of fever and headache
Aspirin is to be avoided to prevent intestinal bleeding.
2.antispasmodic drug to stop abdominal cramps
3.medicine to harden the stools such as kaolin
4.slow down the intestinal movement (lomotil or loperamide).
Prompt treatment may be needed to prevent dehydration:
Dehydration can be caused by diarrhea, excessive sweating from the high fever, or by not drinking enough fluids because of loss of appetite.
Mild dehydration can be treated by drinking liquids.
Severe dehydration may require intravenous fluids.
Untreated severe dehydration can be life threatening especially in babies, young children and the elderly.
Gradually reintroduce food, starting with bland, easy-to-digest food, like porridge or soups.
Get plenty of rest.
Complications such as intestinal perforation may require surgical treatment.
How is Typhoid Fever prevented?
----------------------------------------
Prevention of typhoid is usually by vaccination of all food handlers and staff working in restaurants.
Food handlers should always wash their hands after going to the toilets and before cooking food.
They should always wear gloves when handling or cooking food.
Treatment of chronic typhoid carriers with antibiotics such as ampicillin for 6 months and removal of gallbladder which may harboured the bacteria.
You can avoid infection by:
Avoid eating or drinking foods or liquids that might be contaminated
Good food hygience
Monday, December 3, 2007
A Simple Guide to Athlete's Foot
A Simple Guide to Athlete's Foot
---------------------------------------
What is Athlete's Foot
---------------------------
Athlete's Foot is a common disease caused by superficial fungi infection affecting the webs and toes of the foot
What is the cause of Athlete's Foot?
------------------------------------------
A group of fungi called dermatophytes thrive in the warm, moist environment of webs and toes of the feet caused by trapped sweats and the closed environment of the shoes.
They grow on the keratin a protein found in hair, nails and skin.
Fungal infection is mildly contagious and can spread by direct contact with the infected skin cells found on socks and other clothing.
What are the Symptoms of Athlete's Foot?
------------------------------------------------
Symptoms are:
1.Unpleasant foot odour.
2.Small itchy blisters on the soles of the feet.
3.Itchy, scaly, red rash usually in the webs of the toes.
4.cracked, blistered skin of the toes and nails
5.Dry scaly skin on the soles.
What are the complications of Athlete's foot?
-----------------------------------------------------
Secondary bacterial infections with cellulitis, lymphangitis and lymphadenitis may occur especially in diabetic patients.
What is the Treatment of Athlete's Foot?
---------------------------------------------
1.Antifungal powder, creams and oral medicines
2.basic good foot hygiene
It is important to prevent the fungal infection from spreading.
Avoid scratching of the infected area as this will cause the fungi to spread to other areas.
Dry the feet thoroughly after bathing and before sleep.
Socks or stockings should be changed daily.
Anti fungal powder may be placed in socks before wearing.
Clean and air shoes.
Even after treatment and clearing of the fungal infection, recurrence of the infection may take place because of the presence of spores of the fungus under the skin.
The spores are very resistant to treatment and only when they germinate to the mycelia stage, the fungus can be eliminated through the anti fungal creams, ointment, powder or oral medication.
The antifungal creams must be applied each time there is wetness or trapped sweat so as to get rid of the germinated spores.
Once the spores are completely removed from the skin, then you can be sure that the fungal infection will be unlikely to recur.
Treatment may take up to 6-8 weeks before the fungal infection disappear.
---------------------------------------
What is Athlete's Foot
---------------------------
Athlete's Foot is a common disease caused by superficial fungi infection affecting the webs and toes of the foot
What is the cause of Athlete's Foot?
------------------------------------------
A group of fungi called dermatophytes thrive in the warm, moist environment of webs and toes of the feet caused by trapped sweats and the closed environment of the shoes.
They grow on the keratin a protein found in hair, nails and skin.
Fungal infection is mildly contagious and can spread by direct contact with the infected skin cells found on socks and other clothing.
What are the Symptoms of Athlete's Foot?
------------------------------------------------
Symptoms are:
1.Unpleasant foot odour.
2.Small itchy blisters on the soles of the feet.
3.Itchy, scaly, red rash usually in the webs of the toes.
4.cracked, blistered skin of the toes and nails
5.Dry scaly skin on the soles.
What are the complications of Athlete's foot?
-----------------------------------------------------
Secondary bacterial infections with cellulitis, lymphangitis and lymphadenitis may occur especially in diabetic patients.
What is the Treatment of Athlete's Foot?
---------------------------------------------
1.Antifungal powder, creams and oral medicines
2.basic good foot hygiene
It is important to prevent the fungal infection from spreading.
Avoid scratching of the infected area as this will cause the fungi to spread to other areas.
Dry the feet thoroughly after bathing and before sleep.
Socks or stockings should be changed daily.
Anti fungal powder may be placed in socks before wearing.
Clean and air shoes.
Even after treatment and clearing of the fungal infection, recurrence of the infection may take place because of the presence of spores of the fungus under the skin.
The spores are very resistant to treatment and only when they germinate to the mycelia stage, the fungus can be eliminated through the anti fungal creams, ointment, powder or oral medication.
The antifungal creams must be applied each time there is wetness or trapped sweat so as to get rid of the germinated spores.
Once the spores are completely removed from the skin, then you can be sure that the fungal infection will be unlikely to recur.
Treatment may take up to 6-8 weeks before the fungal infection disappear.
A Simple Guide to Menopause
A Simple Guide to Menopause (Part 2)
----------------------------------------------
How to Treat the symptoms of Menopause?
----------------------------------------------------
In most cases of menopause, no treatment is necessary as it is a normal physiological event.
It is important that there is reassurance and psychological support from family and friends.
Menopause may mean the end of fertility but it also means the freedom from all the discomfort and inconvenience of monthly menstruation and fear of pregnancy.
Hormone replacement therapy used to be the best solution for all the symptoms and problems of menopause at one time.
They help to prevent heart disease and osteoporosis as well as to reduce the symptoms of menopause such as hot flushes, skin , breast and vaginal changes.
Oestrogen and progesterone are the two types of female hormones prescribed for and after menopause.
A combination of the two hormones is taken, as progesterone helps to protect the uterus from endometrial cancer.
If the woman have had removal of the womb, she will normally be given only oestrogen.
HRT can be taken as pills as a single oestogen tablet or as combination of oestrogen and progesterone.
Besides tablets, female hormonal patches, implants or vaginal creams can be used to help replace the level of hormones in the menopausal women.
There are benefits to the use of HRT:
1.Relieves hot flushes
2.reduce vaginal dryness.
3.Prevents osteoporosis and protects against fractures.
4.Indirectly improves mood symptoms by relieving the physical discomfort of menopause.
5.Safe for short term use.
There are also risks in using HRT:
1.increase risk for breast cancer for long term users (>5 years).
2.side effects such as vaginal bleeding, nausea, hair loss and headaches.
3.cause PMS (Pre-Menstrual Syndrome) symptoms such as bloating or irritability.
4.cause venous thrombosis due to increased coagulation of blood.
Hormone replacement therapy has recently fell out of favour due to new study which indicate higher incidence of breast and womb cancer taking HRT over a 5 year period.
It is still prescribed more as a single oestrogen tablet rather than a combination pill of oestrogen and progesterone.
Selective estrogen receptor modulators(SERM) like Evista has been used to replace HRT with good effect.
Plant based female hormones has also being used to reduce the symptoms of menopause. Alternative medicines like evening primrose oil has also been used.
For premature menopause where symptoms of menopause are more obvious due to their age, hormone replacement therapy is still given at intervals of 6 to 12 months.
Besides hormonal therapy, medicines such as:
1200mg of calcium daily
800 to 1000 IU of vitamin D daily
may be able to help prevent osteoporosis.
The current treatment for the symptoms of menopuse in the older women are:
1. A healthy life style.
Exercise
Regular exercise strengthen the muscles and bone.
Exercise also burns up calories to reduce obesity and hence prevent diabetes, hypertension and heart disease.
Walking is one of the best weight-bearing exercises to prevent osteoporosis.
Swimming and dancing are also good exercises.
Eat a balanced diet
A good balanced diet helps to prevent obesity, diabetes, osteoporosis, heart disease and colorectal cancer.
More fruit and vegetables will help reduce calories and prevent colorectal cancer.
Foods rich in calcium and Vitamin D such as fish, low fat high calcium milk can prevent osteoporosis.
Alcohol, coffee, tea, canned drinks should be avoided.
Less sugar, salt and saturated fats will reduce the risk of diabetes,hypertension and heart disease.
Control Stress
Medititation, yoga, deep breathing exercises and sufficient sleep reduces stress and heart disease.
Community service work, hobbies, time with family take the mind off work and stress.
Stay smoke-free
The risk of heart disease, lung and cervical cancer can be reduced by not smoking.
2.hot flushes:
Cool showers and cool tempreatures may help to reduce hot flushes.
Hot beverages and spicy foods should be avoided.
Thin cotton clothes are more comfortable.
Drinking a glass of cold water, loosening any tight clothing and using a small fan to cool down can stop the beginning of a hot flush.
Soy products like tofu and soya bean burns up less calories.
Meditation and mild exercise may also help by reducing stress.
hormone replacement therapy (mainly oestrogen) for a short peroid may be used as a last resort.
3.vaginal changes
Water-soluble vaginal lubricants can reduce dryness.
Oestrogen replacement creams may be prescribed to reduce the vaginal discomfort.
4.incontinence:
Doing simple pelvic floor exercises will strengthen the muscles surrounding the sphincter of the bladder opening.
Wearing a pad in the underwear may reduce the discomfort due to leaks.
Injection of collagen sometimes work to tighten the sphincter of the bladder opening.
Surgery to tighten the muscles of the bladder opening may be used as a last resort.
5.mood changes:
Many women going through menopause may become irritable,anxious or depressed.
Learn how to relax and make time for yourself.
Exercise is good for your health as it keeps your mind off emotional problems!
A hobby or volunteer work that you enjoy may take your mind off your symptoms.
Build up a good support system through talking with friends or a professional counsellor.
6.Osteoporosis:
A balanced diet with adequate calcium and active lifestyle can prevent development of osteoporosis:
Women who are at higher risk are those who
had early menopause or have ovaries removed
have a family history of osteoporosis
have a diet low in calcium and Vitamin D
smoke
are not physically active
are on steroids for long term (E.g. asthmatics)
drink coffee, tea or alcohol regularly
have certain disease such as an overactive thyroid gland
7.Breast Cancer
It is the most common cancer in menpausal women in their 50s.
Early detection by doing monthly breast self examination and a mammography once a year in your 40s and once every two years after age 50 is the best prevention.
8.Cervical Cancer
Cervical cancer is another common cancer among women.
It can be prevented by going for regular Pap smear tests.
Pap smear tests for cervical cancer once every 3 years from age 25 to 65 years if sexually active.
Pap smears can detect precancer so that early treatment can prevent full blown cancer.
9.Regular check-ups
Early detection and checkup can prevent complications such as heart disease and stroke.
A yearly blood pressure with blood sugar and blood cholesterol once every 3 years help to check for danger of heart disease and stroke.
Stay active and be confident about the future.
Take care of your health and personal appearance so that you both look and feel good.
Menopause marks a new Chapter in your life
-----------------------------------------------------
While menopause marks the end of fertility, it is NOT the end of health, or a satisfying and enjoyable life. Menopause means freedom from the inconvenience and discomfort of monthly menses.
Every Woman Goes Through Menopause
Knowledge about menopause is important so that you know what to expect.
Most women welcome the cessation of periods.
Others may feel a sense of loss that their childbearing ability is gone.
By understanding the physical and emotional changes of menopause, more women are able to cope with life in the golden years.
----------------------------------------------
How to Treat the symptoms of Menopause?
----------------------------------------------------
In most cases of menopause, no treatment is necessary as it is a normal physiological event.
It is important that there is reassurance and psychological support from family and friends.
Menopause may mean the end of fertility but it also means the freedom from all the discomfort and inconvenience of monthly menstruation and fear of pregnancy.
Hormone replacement therapy used to be the best solution for all the symptoms and problems of menopause at one time.
They help to prevent heart disease and osteoporosis as well as to reduce the symptoms of menopause such as hot flushes, skin , breast and vaginal changes.
Oestrogen and progesterone are the two types of female hormones prescribed for and after menopause.
A combination of the two hormones is taken, as progesterone helps to protect the uterus from endometrial cancer.
If the woman have had removal of the womb, she will normally be given only oestrogen.
HRT can be taken as pills as a single oestogen tablet or as combination of oestrogen and progesterone.
Besides tablets, female hormonal patches, implants or vaginal creams can be used to help replace the level of hormones in the menopausal women.
There are benefits to the use of HRT:
1.Relieves hot flushes
2.reduce vaginal dryness.
3.Prevents osteoporosis and protects against fractures.
4.Indirectly improves mood symptoms by relieving the physical discomfort of menopause.
5.Safe for short term use.
There are also risks in using HRT:
1.increase risk for breast cancer for long term users (>5 years).
2.side effects such as vaginal bleeding, nausea, hair loss and headaches.
3.cause PMS (Pre-Menstrual Syndrome) symptoms such as bloating or irritability.
4.cause venous thrombosis due to increased coagulation of blood.
Hormone replacement therapy has recently fell out of favour due to new study which indicate higher incidence of breast and womb cancer taking HRT over a 5 year period.
It is still prescribed more as a single oestrogen tablet rather than a combination pill of oestrogen and progesterone.
Selective estrogen receptor modulators(SERM) like Evista has been used to replace HRT with good effect.
Plant based female hormones has also being used to reduce the symptoms of menopause. Alternative medicines like evening primrose oil has also been used.
For premature menopause where symptoms of menopause are more obvious due to their age, hormone replacement therapy is still given at intervals of 6 to 12 months.
Besides hormonal therapy, medicines such as:
1200mg of calcium daily
800 to 1000 IU of vitamin D daily
may be able to help prevent osteoporosis.
The current treatment for the symptoms of menopuse in the older women are:
1. A healthy life style.
Exercise
Regular exercise strengthen the muscles and bone.
Exercise also burns up calories to reduce obesity and hence prevent diabetes, hypertension and heart disease.
Walking is one of the best weight-bearing exercises to prevent osteoporosis.
Swimming and dancing are also good exercises.
Eat a balanced diet
A good balanced diet helps to prevent obesity, diabetes, osteoporosis, heart disease and colorectal cancer.
More fruit and vegetables will help reduce calories and prevent colorectal cancer.
Foods rich in calcium and Vitamin D such as fish, low fat high calcium milk can prevent osteoporosis.
Alcohol, coffee, tea, canned drinks should be avoided.
Less sugar, salt and saturated fats will reduce the risk of diabetes,hypertension and heart disease.
Control Stress
Medititation, yoga, deep breathing exercises and sufficient sleep reduces stress and heart disease.
Community service work, hobbies, time with family take the mind off work and stress.
Stay smoke-free
The risk of heart disease, lung and cervical cancer can be reduced by not smoking.
2.hot flushes:
Cool showers and cool tempreatures may help to reduce hot flushes.
Hot beverages and spicy foods should be avoided.
Thin cotton clothes are more comfortable.
Drinking a glass of cold water, loosening any tight clothing and using a small fan to cool down can stop the beginning of a hot flush.
Soy products like tofu and soya bean burns up less calories.
Meditation and mild exercise may also help by reducing stress.
hormone replacement therapy (mainly oestrogen) for a short peroid may be used as a last resort.
3.vaginal changes
Water-soluble vaginal lubricants can reduce dryness.
Oestrogen replacement creams may be prescribed to reduce the vaginal discomfort.
4.incontinence:
Doing simple pelvic floor exercises will strengthen the muscles surrounding the sphincter of the bladder opening.
Wearing a pad in the underwear may reduce the discomfort due to leaks.
Injection of collagen sometimes work to tighten the sphincter of the bladder opening.
Surgery to tighten the muscles of the bladder opening may be used as a last resort.
5.mood changes:
Many women going through menopause may become irritable,anxious or depressed.
Learn how to relax and make time for yourself.
Exercise is good for your health as it keeps your mind off emotional problems!
A hobby or volunteer work that you enjoy may take your mind off your symptoms.
Build up a good support system through talking with friends or a professional counsellor.
6.Osteoporosis:
A balanced diet with adequate calcium and active lifestyle can prevent development of osteoporosis:
Women who are at higher risk are those who
had early menopause or have ovaries removed
have a family history of osteoporosis
have a diet low in calcium and Vitamin D
smoke
are not physically active
are on steroids for long term (E.g. asthmatics)
drink coffee, tea or alcohol regularly
have certain disease such as an overactive thyroid gland
7.Breast Cancer
It is the most common cancer in menpausal women in their 50s.
Early detection by doing monthly breast self examination and a mammography once a year in your 40s and once every two years after age 50 is the best prevention.
8.Cervical Cancer
Cervical cancer is another common cancer among women.
It can be prevented by going for regular Pap smear tests.
Pap smear tests for cervical cancer once every 3 years from age 25 to 65 years if sexually active.
Pap smears can detect precancer so that early treatment can prevent full blown cancer.
9.Regular check-ups
Early detection and checkup can prevent complications such as heart disease and stroke.
A yearly blood pressure with blood sugar and blood cholesterol once every 3 years help to check for danger of heart disease and stroke.
Stay active and be confident about the future.
Take care of your health and personal appearance so that you both look and feel good.
Menopause marks a new Chapter in your life
-----------------------------------------------------
While menopause marks the end of fertility, it is NOT the end of health, or a satisfying and enjoyable life. Menopause means freedom from the inconvenience and discomfort of monthly menses.
Every Woman Goes Through Menopause
Knowledge about menopause is important so that you know what to expect.
Most women welcome the cessation of periods.
Others may feel a sense of loss that their childbearing ability is gone.
By understanding the physical and emotional changes of menopause, more women are able to cope with life in the golden years.
Saturday, December 1, 2007
A Simple Guide to Menopause
A Simple Guide to Menopause(Part 1)
---------------------------------------------
What is Menopause?
-------------------------
Menopause is the cessation of menstruation occuring in women between the ages of 45 and 55 years.
It is important to stress that it is NOT an illness but a natural event.
The age that menopause occur may vary with different women.
What Causes Menopause?
--------------------------------
Natural Menopause
------------------------
From puberty a woman starts releasing eggs from their ovaries.
Both the ovaries and eggs produces female hormones.
These hormones thickens lining of the womb in preparation for a pregnancy.
If the pregnancy does not occur, the lining of the womb is shed off as blood and cells(menses).
As the woman grows older, less eggs are produced resulting in reduced production of the female hormones.
This causes the menstrual periods to be less or more than usual.
When no more eggs are produced, the amount of the hormones produced are not enough to cause the lining of the womb to thicken.
As a result menstruation will stop.
Menopause is said to be established when the woman does not have any menstruation for one year.
Premature Menopause
---------------------------
Premature menopause occurs when the menses stop in a woman before the age of 40 yrs.
The causes of premature menopause are
1.surgery to remove the womb or ovaries in the case of cancer,
2. chemotherapy and
3. radiotherapy.
Without the protective effect of oestrogen, these young women will have a higher chance of having osteoporosis and heart disease later in life .
Women who smokes usually have menopause 2 years earlier than non-smokers.
What are the symptoms and signs in Menopause?
----------------------------------------------------------
Most women do not have any symptoms except for the loss of their monthly periods.
In others, the change in female hormones may cause the following symptoms:
1.Irregular menstrual patterns - usually the menses can become lighter or further apart.
One or two periods may be missed.
2.Hot flushes -sudden feeling of heat starting from the chest to the face.
There may be associated sweating, fast heart beats, fainting and insomnia.
The exact cause is not known and may be due to vasomotor disturbances related to the fluctuating hormone levels.
It usually improve after 1-2 years.
3.Vaginal tract changes - With menopause, the walls of the vagina become thinner, dryer because of less secretions, and more prone to infection.
Because ot these changes, sexual intercourse may be uncomfortable or painful.
3.Incontinence - With age and onset of menopause, the muscles around the bladder opening may weaken, leading to leakage of urine with straining or coughing (incontinence).
Muscles of pelvic floor loses tone with possible prolapse of uterus.
4.Breasts tissues may become atrophied with decrease in size of the nipples.
The breast may become more pendulous.
5.Skin may be less smooth and wrinkles may appear.
Hair may also become thinner and dryer.
6.Mood and memory: irritability, anxiety, depression, insomnia (difficulty in sleeping), poor concentration and poor memory may be due to the lowered female hormones or pyschological due to change in the body, skin and appearance.
What are complications of Menopause?
-----------------------------------------------
1.Osteoporosis:
The bones may become brittle, fragile and fracture easily after menopause because oestrogen is important in maintaining bone mass.
Hormone replacement may be able to reduce the bone loss and prevent osteoporosis.
2.Cancer:
Menopause itself does not cause an increased risk of women cancer.
It is rather the age group that they are in which may increase the risk of cancer.
3.Heart disease and stroke
After menopause, women are more likely to get hypertension or high blood cholesterol which increases the risk of a heart attack and stroke.
4.Metabolic disease
Again after menopause, some women tend to burn less energy and gain weight.
Decrease in metabolism leads to accumulation of sugars which can increase the risk of Diabetes
---------------------------------------------
What is Menopause?
-------------------------
Menopause is the cessation of menstruation occuring in women between the ages of 45 and 55 years.
It is important to stress that it is NOT an illness but a natural event.
The age that menopause occur may vary with different women.
What Causes Menopause?
--------------------------------
Natural Menopause
------------------------
From puberty a woman starts releasing eggs from their ovaries.
Both the ovaries and eggs produces female hormones.
These hormones thickens lining of the womb in preparation for a pregnancy.
If the pregnancy does not occur, the lining of the womb is shed off as blood and cells(menses).
As the woman grows older, less eggs are produced resulting in reduced production of the female hormones.
This causes the menstrual periods to be less or more than usual.
When no more eggs are produced, the amount of the hormones produced are not enough to cause the lining of the womb to thicken.
As a result menstruation will stop.
Menopause is said to be established when the woman does not have any menstruation for one year.
Premature Menopause
---------------------------
Premature menopause occurs when the menses stop in a woman before the age of 40 yrs.
The causes of premature menopause are
1.surgery to remove the womb or ovaries in the case of cancer,
2. chemotherapy and
3. radiotherapy.
Without the protective effect of oestrogen, these young women will have a higher chance of having osteoporosis and heart disease later in life .
Women who smokes usually have menopause 2 years earlier than non-smokers.
What are the symptoms and signs in Menopause?
----------------------------------------------------------
Most women do not have any symptoms except for the loss of their monthly periods.
In others, the change in female hormones may cause the following symptoms:
1.Irregular menstrual patterns - usually the menses can become lighter or further apart.
One or two periods may be missed.
2.Hot flushes -sudden feeling of heat starting from the chest to the face.
There may be associated sweating, fast heart beats, fainting and insomnia.
The exact cause is not known and may be due to vasomotor disturbances related to the fluctuating hormone levels.
It usually improve after 1-2 years.
3.Vaginal tract changes - With menopause, the walls of the vagina become thinner, dryer because of less secretions, and more prone to infection.
Because ot these changes, sexual intercourse may be uncomfortable or painful.
3.Incontinence - With age and onset of menopause, the muscles around the bladder opening may weaken, leading to leakage of urine with straining or coughing (incontinence).
Muscles of pelvic floor loses tone with possible prolapse of uterus.
4.Breasts tissues may become atrophied with decrease in size of the nipples.
The breast may become more pendulous.
5.Skin may be less smooth and wrinkles may appear.
Hair may also become thinner and dryer.
6.Mood and memory: irritability, anxiety, depression, insomnia (difficulty in sleeping), poor concentration and poor memory may be due to the lowered female hormones or pyschological due to change in the body, skin and appearance.
What are complications of Menopause?
-----------------------------------------------
1.Osteoporosis:
The bones may become brittle, fragile and fracture easily after menopause because oestrogen is important in maintaining bone mass.
Hormone replacement may be able to reduce the bone loss and prevent osteoporosis.
2.Cancer:
Menopause itself does not cause an increased risk of women cancer.
It is rather the age group that they are in which may increase the risk of cancer.
3.Heart disease and stroke
After menopause, women are more likely to get hypertension or high blood cholesterol which increases the risk of a heart attack and stroke.
4.Metabolic disease
Again after menopause, some women tend to burn less energy and gain weight.
Decrease in metabolism leads to accumulation of sugars which can increase the risk of Diabetes
Wednesday, November 28, 2007
A Simple Guide to Folliculitis
A Simple Guide to Folliculitis
-----------------------------------------
What is Folliculitis?
--------------------------
Folliculitis is an infection of the hair follicles.
What are the causes of Folliculitis?
-------------------------------------
Folliculitis may occur after:
1. abrasions or wounds on the skin
2.friction due to tight clothing
3.eczema or dermatitis
4.diabetes or leukemia patients are more susceptible to infection
The bacteria causing the folliculitis is usually staphylococcus aureus.
What are the symptoms and signs of Folliculitis?
---------------------------------------------
There is usually a superficial pustule or inflammatory nodule surrounding the base of a hair.
They may occur all around the same area or scattered on the body.
Chronic Folliculitis may occur around the beard area.(sycosis barbae)
What are the complications of Folliculitis?
-------------------------------------------
The inflammatory nodule of Folliculitis may develop into a pustule with cental necrosis and discharge of pus and sometimes blood stained material.
This is a furuncle or boil.
A group of furuncles can merge and become a larger entity called a carbuncle which is deep and wide .
What is the treatment of Folliculitis?
---------------------------------------
Most mild Folliculitis may disappear by itself without treatment after a few days.
The severe cases requires topical antibiotic creams like bactroban or systemic antibiotics to clear the infections.
Carbuncles may need surgical treatment.
-----------------------------------------
What is Folliculitis?
--------------------------
Folliculitis is an infection of the hair follicles.
What are the causes of Folliculitis?
-------------------------------------
Folliculitis may occur after:
1. abrasions or wounds on the skin
2.friction due to tight clothing
3.eczema or dermatitis
4.diabetes or leukemia patients are more susceptible to infection
The bacteria causing the folliculitis is usually staphylococcus aureus.
What are the symptoms and signs of Folliculitis?
---------------------------------------------
There is usually a superficial pustule or inflammatory nodule surrounding the base of a hair.
They may occur all around the same area or scattered on the body.
Chronic Folliculitis may occur around the beard area.(sycosis barbae)
What are the complications of Folliculitis?
-------------------------------------------
The inflammatory nodule of Folliculitis may develop into a pustule with cental necrosis and discharge of pus and sometimes blood stained material.
This is a furuncle or boil.
A group of furuncles can merge and become a larger entity called a carbuncle which is deep and wide .
What is the treatment of Folliculitis?
---------------------------------------
Most mild Folliculitis may disappear by itself without treatment after a few days.
The severe cases requires topical antibiotic creams like bactroban or systemic antibiotics to clear the infections.
Carbuncles may need surgical treatment.
Tuesday, November 27, 2007
A Simple guide to Whooping Cough
A Simple guide to Whooping Cough
------------------------------------
What is Whooping Cough?
-----------------------
Whooping cough is an acute infectious childhood disease of the respiratory tract caused by the bacillus Bordetella pertussis.
How is Whooping Cough transmitted?
---------------------------------
Whooping Cough is transmitted by droplets from coughing spells.
It is highly infectious.
The early stage when it appears to be a cold is the most infectious peroid.
Most infections occur in children under six years of age.
One attack usually confers immunity
What are the Signs and Symptoms of Whooping Cough?
---------------------------------------------------
The incubation peroid is usually 10 - 12 days after contact with an infected child.
Symptoms start off with:
1.an ordinary cold (runny nose, sneezing, cough, fever) for 1-2 weeks followed by:
2.uncontrolled coughing that can last 1 - 2 months.
Cough persists and become paroxysmal ending in a noisy inspiration "whoop" sound causing the child to go blue and vomit.
Between the spasms of coughing the child seems relatively well
What are the complications of Whooping Cough?
---------------------------------------------
The worst affected are children below the 1 year old.
Some serious complications are:
1.pneumonia,
2.seizures,
3.brain damage
4.nose bleeds
5.death can occur during the severe coughing stage.
Serious complications are less with older children or adults.
Adults rarely get whooping cough because their immmunity from vaccination usually last 10 years after the last dose.
When adults get whooping cough, a prolonged, irritating cough may be present instead of whooping type of cough.
What is the Treatment of Whooping Cough?
--------------------------------------------
Antibiotics (erythromycin) are used in the treatment of Whooping cough.
Once severe coughing has begun, antibiotics are less effective. They can reduce the duration of the illness and stop the spread to others.
Family members should be treated once there is an infected person.
Tetracycline is used if the patient is allergic to erythromycin but should avoided in children because of the staining of the teeth.
Besides antibiotics, the following will help:
1.Steam inhalation
2.cough mixtures
3.oxygen therapy
4.avoid smokes, dust, dry air,sudden temperature change
What is the Prevention for Whooping Cough?
-----------------------------------------
Vaccination against whooping cough is the best prevention .
Since vaccination began, the worldwide incidence of whooping cough has declined.
Vaccination against diphtheria, pertussis (whooping cough), tetanus (DPT) is usually given to a baby at 3 months of age and repeated at 4 and 5 months of age.
There is a booster vaccination at 18 months.
In very rare cases (1 in 100,000 cases), there has been serious reactions such as seizures to the whooping cough part of the vaccination.
Recently, an improved acellular pertussis vaccine is now available. There are fewer side effects such as high fever and seizureswith this new vaccine.
------------------------------------
What is Whooping Cough?
-----------------------
Whooping cough is an acute infectious childhood disease of the respiratory tract caused by the bacillus Bordetella pertussis.
How is Whooping Cough transmitted?
---------------------------------
Whooping Cough is transmitted by droplets from coughing spells.
It is highly infectious.
The early stage when it appears to be a cold is the most infectious peroid.
Most infections occur in children under six years of age.
One attack usually confers immunity
What are the Signs and Symptoms of Whooping Cough?
---------------------------------------------------
The incubation peroid is usually 10 - 12 days after contact with an infected child.
Symptoms start off with:
1.an ordinary cold (runny nose, sneezing, cough, fever) for 1-2 weeks followed by:
2.uncontrolled coughing that can last 1 - 2 months.
Cough persists and become paroxysmal ending in a noisy inspiration "whoop" sound causing the child to go blue and vomit.
Between the spasms of coughing the child seems relatively well
What are the complications of Whooping Cough?
---------------------------------------------
The worst affected are children below the 1 year old.
Some serious complications are:
1.pneumonia,
2.seizures,
3.brain damage
4.nose bleeds
5.death can occur during the severe coughing stage.
Serious complications are less with older children or adults.
Adults rarely get whooping cough because their immmunity from vaccination usually last 10 years after the last dose.
When adults get whooping cough, a prolonged, irritating cough may be present instead of whooping type of cough.
What is the Treatment of Whooping Cough?
--------------------------------------------
Antibiotics (erythromycin) are used in the treatment of Whooping cough.
Once severe coughing has begun, antibiotics are less effective. They can reduce the duration of the illness and stop the spread to others.
Family members should be treated once there is an infected person.
Tetracycline is used if the patient is allergic to erythromycin but should avoided in children because of the staining of the teeth.
Besides antibiotics, the following will help:
1.Steam inhalation
2.cough mixtures
3.oxygen therapy
4.avoid smokes, dust, dry air,sudden temperature change
What is the Prevention for Whooping Cough?
-----------------------------------------
Vaccination against whooping cough is the best prevention .
Since vaccination began, the worldwide incidence of whooping cough has declined.
Vaccination against diphtheria, pertussis (whooping cough), tetanus (DPT) is usually given to a baby at 3 months of age and repeated at 4 and 5 months of age.
There is a booster vaccination at 18 months.
In very rare cases (1 in 100,000 cases), there has been serious reactions such as seizures to the whooping cough part of the vaccination.
Recently, an improved acellular pertussis vaccine is now available. There are fewer side effects such as high fever and seizureswith this new vaccine.
Monday, November 26, 2007
A Simple Guide to Dysmenorrhea
A Simple Guide to Dysmenorrhea
----------------------------------------
What is Dysmenorrhea?
-----------------------------
Dysmenorrhea is a symptom, not an illness.
It means painful menstruation.
What are the types of Dysmenorrhea?
--------------------------------------------
Dysmenorrhea may be classified into:
1.Primary or Spasmodic Dysmenorrhea
2.Secondary Dysmenorrhea due to causes like
Endometriosis or
Pelvic Inflammatory Disease
What are the Causes of Dysmenorrhea?
----------------------------------------------
The cause of primary Dysmenorrhea is still not known.
There are a few theories:
1.during menstruation, contraction of the uterine muscles occurs in spasms trying to push the menstrual flow through a narrow cervical opening
2.Prostagladins output occurs at time of menstruation producing muscles spasms
3.Menstrual clots occludes the uterine opening and requires more contractions of the uterine muscles to push it through
4.Stress may constrict the opening of the uterus and hence greater contraction of the uterine muscles is required to force out the menstrual flow.
What are the Symptoms of Dysmenorrhea?
--------------------------------------------------
Primary Dysmenorrhea:
----------------------------
1.typically occurs on the first day of menses and becomes less after the 2nd day.
2.lower abdominal cramp radiating down to thighs and back
Secondary Dysmenorrhea:
-------------------------------
1. Starts about 1 week before menses and reach maximum on first day before reducing intensity for rest of menses peroid
2.dull aching pain in lower abdomen with radiation to the back
Symptoms may be associated with
1.vomiting,
2.urinary frequency,
3.headache,
4.painful breasts,
5.abdominal distension,
6.depression and
7.irritabilty.
What is the Treatment for Dysmenorrhea?
--------------------------------------------------
Primary Dysmenorrhea:
----------------------------
1.simple analgesics like paracetamol
2.Non-steroidal anti-infammatory drugs like Ponstan, Synflex
3.Antispasmodics
4.Tranquilliser or antidepressant
5.Muscle relaxant
6.female hormones
Secondary Dysmenorrhea:
-----------------------------------
1.Identify and treat the underlying cause(eg. antibiotics for PID)
2.Endometriosis may require a course of female hormones or surgery for control
3.Dilatation of the endocervical canal may help
What is the prognosis of Dysmenorrhea?
------------------------------------------------
Primary Dysmenorrhea may end with first pregnancy due to widening of uterine opening.
Secondary Dysmenorrhea prognosis depends on the treatment of causes.
----------------------------------------
What is Dysmenorrhea?
-----------------------------
Dysmenorrhea is a symptom, not an illness.
It means painful menstruation.
What are the types of Dysmenorrhea?
--------------------------------------------
Dysmenorrhea may be classified into:
1.Primary or Spasmodic Dysmenorrhea
2.Secondary Dysmenorrhea due to causes like
Endometriosis or
Pelvic Inflammatory Disease
What are the Causes of Dysmenorrhea?
----------------------------------------------
The cause of primary Dysmenorrhea is still not known.
There are a few theories:
1.during menstruation, contraction of the uterine muscles occurs in spasms trying to push the menstrual flow through a narrow cervical opening
2.Prostagladins output occurs at time of menstruation producing muscles spasms
3.Menstrual clots occludes the uterine opening and requires more contractions of the uterine muscles to push it through
4.Stress may constrict the opening of the uterus and hence greater contraction of the uterine muscles is required to force out the menstrual flow.
What are the Symptoms of Dysmenorrhea?
--------------------------------------------------
Primary Dysmenorrhea:
----------------------------
1.typically occurs on the first day of menses and becomes less after the 2nd day.
2.lower abdominal cramp radiating down to thighs and back
Secondary Dysmenorrhea:
-------------------------------
1. Starts about 1 week before menses and reach maximum on first day before reducing intensity for rest of menses peroid
2.dull aching pain in lower abdomen with radiation to the back
Symptoms may be associated with
1.vomiting,
2.urinary frequency,
3.headache,
4.painful breasts,
5.abdominal distension,
6.depression and
7.irritabilty.
What is the Treatment for Dysmenorrhea?
--------------------------------------------------
Primary Dysmenorrhea:
----------------------------
1.simple analgesics like paracetamol
2.Non-steroidal anti-infammatory drugs like Ponstan, Synflex
3.Antispasmodics
4.Tranquilliser or antidepressant
5.Muscle relaxant
6.female hormones
Secondary Dysmenorrhea:
-----------------------------------
1.Identify and treat the underlying cause(eg. antibiotics for PID)
2.Endometriosis may require a course of female hormones or surgery for control
3.Dilatation of the endocervical canal may help
What is the prognosis of Dysmenorrhea?
------------------------------------------------
Primary Dysmenorrhea may end with first pregnancy due to widening of uterine opening.
Secondary Dysmenorrhea prognosis depends on the treatment of causes.
Sunday, November 25, 2007
A Simple Guide to Laryngitis
A Simple Guide to Laryngitis
----------------------------------
What is Laryngitis?
------------------------
Laryngitis is the inflammation of the mucous membranes of the Laryngx which produces the sound of the voice.
What causes the Laryngitis?
---------------------------------
Laryngitis is caused by
1.bacterial or viral infections of the larynx.
2.excessive use of voice
3.inhalation of irritants such as cigarette smoke
Laryngitis is also associated with
1.bronchitis
2.pneumonia
3.whooping cough
4.diphtheria
What are the Symptoms of the Laryngitis?
--------------------------------------------------
Laryngitis produces mild but uncomfortable symptoms:
1.hoarseness of voice
2.loss of voice
3.pain on speaking
4.Fever low grade rare
How is the diagnosis of Laryngitis confirmed?
------------------------------------------------------
1.Symptoms of hoarseness or loss of voice
2.Physical examination of the throat may showed the presence of redness and swelling of the vocal cords with some pus discharge.
The movement of the vocal cords may be impeded.
Sometimes nodules may be found on the vocal cord due to excessive usage of voice.
What are the investigations done in Laryngitis?
-----------------------------------------------------------
1.nasal and throat swabs to determine the type of infection
2.Xray of the chest and neck to determine any pressure of other organs pressing on the larynx
3.A biopsy of the nodules on the vocal cords if present to exclude malignancy
What is the Treatment of Laryngitis?
---------------------------------------------
1.Rest the voice. A rested patient will recover faster.
2.Adequate warm fluids helps to keep the mucus membranes moist
3.Steam inhalations may help
4.Antibiotics if there is suspicion of bacterial infection.
5.Gargles and decongestants may help to soothe the throat and vocal cords
6.Avoid smoking.
What is the prognosis of Laryngitis?
------------------------------------------
Acute laryngitis usually clears up within 10 days.
Very rarely chronic laryngitis may cause hoarseness of voice for months or years.
----------------------------------
What is Laryngitis?
------------------------
Laryngitis is the inflammation of the mucous membranes of the Laryngx which produces the sound of the voice.
What causes the Laryngitis?
---------------------------------
Laryngitis is caused by
1.bacterial or viral infections of the larynx.
2.excessive use of voice
3.inhalation of irritants such as cigarette smoke
Laryngitis is also associated with
1.bronchitis
2.pneumonia
3.whooping cough
4.diphtheria
What are the Symptoms of the Laryngitis?
--------------------------------------------------
Laryngitis produces mild but uncomfortable symptoms:
1.hoarseness of voice
2.loss of voice
3.pain on speaking
4.Fever low grade rare
How is the diagnosis of Laryngitis confirmed?
------------------------------------------------------
1.Symptoms of hoarseness or loss of voice
2.Physical examination of the throat may showed the presence of redness and swelling of the vocal cords with some pus discharge.
The movement of the vocal cords may be impeded.
Sometimes nodules may be found on the vocal cord due to excessive usage of voice.
What are the investigations done in Laryngitis?
-----------------------------------------------------------
1.nasal and throat swabs to determine the type of infection
2.Xray of the chest and neck to determine any pressure of other organs pressing on the larynx
3.A biopsy of the nodules on the vocal cords if present to exclude malignancy
What is the Treatment of Laryngitis?
---------------------------------------------
1.Rest the voice. A rested patient will recover faster.
2.Adequate warm fluids helps to keep the mucus membranes moist
3.Steam inhalations may help
4.Antibiotics if there is suspicion of bacterial infection.
5.Gargles and decongestants may help to soothe the throat and vocal cords
6.Avoid smoking.
What is the prognosis of Laryngitis?
------------------------------------------
Acute laryngitis usually clears up within 10 days.
Very rarely chronic laryngitis may cause hoarseness of voice for months or years.
Saturday, November 24, 2007
A Simple Guide to Leprosy
A Simple Guide to Leprosy
----------------------------------
What is Leprosy?
---------------------
Leprosy or Hansen's disease is a chronic granulomatous disease caused by the bacteria mycobacterium leprae.
Who is at risk of contacting Leprosy?
--------------------------------------------
At present 10 countries: Brazil, Democratic Republic of the Congo, Guinea, India, Indonesia, Madagascar, Mozambique, Myanmar, Nepal and Tanzania account for 90 per cent of the disease in the world.
The disease affects mainly young people between 10-20 years of age, males more than females.
The exact mode of spread is unclear.
It is believed to be from person to person via nasal discharge, respiratory droplets and skin contact.
People prone to contacting the disease have:
1.weak immune system -these people develop multibacillary leprosy which is infectious,
Those with a stronger immune system develop paucibacillary leprosy which is non-infectious:
2.malnutrition and
3.unhygienic and crowded living conditions
What are the Signs & Symptoms of Leprosy?
----------------------------------------------------
The incubation period can vary from 1 year - 40 years.
Paucibacillary leprosy:
1.milder and non-infectious
2.one or more hypopigmented skin macules with loss of sensation.
3.Peripheral nerves may be damaged and enlarged.
Multibacillary leprosy :
1.numerous shiny, reddish nodules, thickened skin,
2.nasal discharge, nasal congestion and bleeding from the nose.
3.Distal peripheral nerves are thickened, enlarged and painful.
4.loss of eyelashes and eyebrows.
5.Skin smears are always positive for bacilli.
How is the diagnosis of Leprosy made:
---------------------------------------------
Diagnosis of leprosy is based on the following signs:
1.chronic skin lesions,
2.peripheral neuropathy,
3.thickened nerves,
4.muscle weakness
Confirmation of diagnosis is by
1.biopsy of skin lesions and thickened nerve.
2.Nasal and skin smears may show presence of leprosy bacteria.
What are the Complications of Leprosy?
------------------------------------------------
Complications include
1.damage to the peripheral nerves
2.numbness,
3.muscle weakness
4.paralysis with consequent claw hand or foot drop
5.skin 6. painful skin nodules.
6.loss of sensation, with resultant injuries
8.infections from injuries which can cause ulcers that damage the dermal tissues,
9.joints and bones infections resulting in the loss of extremities (toes and fingers)
10.secondary crippling deformities can occur in 25 per cent of cases not treated at an early stage.
What is the Treatment of Leprosy?
-----------------------------------------
Leprosy can be cured.
Early Treatment averts disability.
Multidrug therapy (MDT) consists of three drugs:
dapsone,
rifampicin and
clofazimine.
This drug combination effectively kills leprosy bacteria.
It prevents mutilations and deformities.
The 80 per cent with paucibacillary leprosy (PB) are non-infectious and cured within six months.
The remaining 20 to 30 per cent with the multibacillary form (MB) are cured within one year.
The drugs are safe with little side effects.
After the first dose of MDT, the patients are no longer infectious .
There is virtually no recurrence of the disease with treatment.
No resistance of the bacillus to MDT has been detected.
The chain of transmission of the leprosy is stopped.
What is the Preventive measures for Leprosy?
------------------------------------------------------
Prevention measures are:
1. early detection and treatment with MDT has prevented about 3 to 4 million people from being disabled.
2.Better hygience and nutrition
3.Better living conditions
Friday, November 23, 2007
A Simple Guide to Pelvic Inflammatory Disease
A Simple Guide to Pelvic Inflammatory Disease
--------------------------------------------------------
What is Pelvic Inflammatory Disease?
---------------------------------------------
Pelvic inflammatory disease (PID) is a general term used to describe inflammatory disorders of the upper female genital tract, such as infection of the uterus, fallopian tubes, ovaries and tissues around the reproductive organs.
These include endometritis, salpingitis, tubo-ovarian abscess, and pelvic peritonitis.
What is the cause of PID?
------------------------------
It is the result of infection from some sexually transmitted diseases especially chlamydia and gonorrhea.
The fallopian tubes and tissues in and near the uterus and ovaries are the most frequent organs damaged.
Sexually active women in their childbearing years are most likely to get PID.
Women under age 25 are more likely to develop PID than those older than 25.
The cervix of young women is not fully matured, and therefore more prone to be infected by STD.
Vaginal douching in women changes the vaginal bacteria flora in harmful ways, and can also force bacteria into the upper reproductive organs from the vagina.
Women with an intrauterine device (IUD) inserted has an increased risk of PID compared with women using other contraceptives or no contraceptive at all.
What are the signs and symptoms of PID?
--------------------------------------------------
Symptoms of PID can vary widely.
Women whose PID is caused by chlamydial infection may have mild symptoms or no symptoms at all even as serious damage is being done to her reproductive organs. Most cases of PID are not detected about two thirds of the time.
Common symptoms of PID are
1.lower abdominal pain
2.fever,
3.unusual vaginal discharge with a foul odor,
4.painful intercourse,
5.painful urination,
6.irregular menstrual bleeding, and
7.pain in the right upper abdomen (rare).
How is PID diagnosed?
---------------------------
Because the symptoms are often subtle and mild, most cases of PID go undetected.
Diagnosis is usually based on clinical findings:
1.lower abdominal pain
2.abnormal cervical or vaginal mucopurulent discharge
3.oral temperature >101°F (>38.3°C)
together with investigation findings
4.laboratory evidence of gonorrheal or chlamydial infection.
5.A wet specimen of vaginal fluid is able to detect the presence of concomitant infections ( bacterial vaginosis and trichomoniasis)
6. pelvic ultrasound is a helpful procedure for diagnosing PID.It can check the pelvic area to see whether there is an abscess or enlarged fallopian tubes.
7.laparoscopy is a minor surgical procedure in which a thin, flexible tube with a lighted end in inserted through a cut in the navel area to view the internal pelvic organs and to take specimens for testing.
Other criteria for diagnosing PID include the following:
8.endometrial biopsy with histopathologic evidence of endometritis;
9.transvaginal sonography or magnetic resonance imaging techniques showing thickened, fluid-filled tubes with or without free pelvic fluid or tubo-ovarian complex,
10.doppler studies suggesting pelvic infection
What are the complications of PID?
-----------------------------------------
Prompt and appropriate treatment can help prevent complications of PID.
Without treatment, PID can cause
1. permanent damage to the female reproductive organs.
Infection-causing bacteria can invade the fallopian tubes, damaging the lining of the tubes causing blockage of the fallopian tubes and preventing sperm from fertilising an egg.
2.Infertility also occur when the fallopian tubes are partially blocked or even slightly damaged as therm may find it difficult to reach the egg.
3.ectopic pregnancy may occur when the fertilized egg remains in the partially blocked fallopian tube and begins to grow.
As it grows, an ectopic pregnancy can cause rupture of the fallopian tube resulting in abdominal pain, internal bleeding, and death.
4.chronic pelvic pain that lasts for months or even years due to the inflammation, damage to the pelvic organs, and contraction of the scarred tissues.
5.endometrosis are blood clots in the pelvic region which occurs due to inflammation of the pelvis and can also cause pain during menses.
6. abscess formation in the reproductive organs or pelvis which can spread to the blood and cause septicemia.
What is the treatment for PID?
-------------------------------------
Treatment of PID should be initiated in
1.sexually active young women
2. pelvic or lower abdominal pain,
3. physical examination shows cervical motion tenderness, uterine tenderness or adnexal tenderness.
PID can be treated with several types of antibiotics(eg.clindamycin or metronidazole with doxycycline).
However, antibiotic treatment will not reverse any damage to the reproductive organs. If a woman has pelvic pain and other symptoms of PID, it is important that she seek care immediately.
Prompt antibiotic treatment can prevent severe damage to reproductive organs.
PID is usually treated with at least two antibiotics given by mouth or by injection.
Even if symptoms go away, the woman should finish taking all of the prescribed medicine.
This will help prevent the infection from returning.
Hospitalization to treat PID may be recommended if the woman
(1) is severely ill with nausea, vomiting, and high fever
(2) is pregnant;
(3) does not respond to or cannot take oral medication and needs intravenous antibiotics;
(4) has an abscess in the fallopian tube or ovary (tubo-ovarian abscess).
(5)surgical emergencies (e.g., appendicitis) cannot be excluded;
If symptoms continue or if an abscess does not go away, surgery may be needed.
Complications of PID such as chronic pelvic pain and scarring improve with surgery.
How can PID be prevented?
--------------------------------
1. transmission of STDs can be prevented by abstainance from sexual intercourse,
2. a long-term mutually monogamous relationship with a partner who has been tested and is known to be uninfected can prevent STD.
3.Latex male condoms, when used consistently and correctly, can reduce the transmission of chlamydia and gonorrhea.
4.chlamydia testing of all sexually active women age 25 or younger and of older women with risk factors for chlamydial infections especially those with a new sex partner or multiple sex partners
5.Any genital symptoms such as an unusual sore, discharge with odor, burning during urination, or bleeding between menstrual cycles suggests a STD infection. Early treatment of STDs can prevent PID.
6. Intrauterine contraceptive devices containing levonorgestrel-and copper-containing devices may cause PID and should be removed if antibiotics does not cure the PID.
--------------------------------------------------------
What is Pelvic Inflammatory Disease?
---------------------------------------------
Pelvic inflammatory disease (PID) is a general term used to describe inflammatory disorders of the upper female genital tract, such as infection of the uterus, fallopian tubes, ovaries and tissues around the reproductive organs.
These include endometritis, salpingitis, tubo-ovarian abscess, and pelvic peritonitis.
What is the cause of PID?
------------------------------
It is the result of infection from some sexually transmitted diseases especially chlamydia and gonorrhea.
The fallopian tubes and tissues in and near the uterus and ovaries are the most frequent organs damaged.
Sexually active women in their childbearing years are most likely to get PID.
Women under age 25 are more likely to develop PID than those older than 25.
The cervix of young women is not fully matured, and therefore more prone to be infected by STD.
Vaginal douching in women changes the vaginal bacteria flora in harmful ways, and can also force bacteria into the upper reproductive organs from the vagina.
Women with an intrauterine device (IUD) inserted has an increased risk of PID compared with women using other contraceptives or no contraceptive at all.
What are the signs and symptoms of PID?
--------------------------------------------------
Symptoms of PID can vary widely.
Women whose PID is caused by chlamydial infection may have mild symptoms or no symptoms at all even as serious damage is being done to her reproductive organs. Most cases of PID are not detected about two thirds of the time.
Common symptoms of PID are
1.lower abdominal pain
2.fever,
3.unusual vaginal discharge with a foul odor,
4.painful intercourse,
5.painful urination,
6.irregular menstrual bleeding, and
7.pain in the right upper abdomen (rare).
How is PID diagnosed?
---------------------------
Because the symptoms are often subtle and mild, most cases of PID go undetected.
Diagnosis is usually based on clinical findings:
1.lower abdominal pain
2.abnormal cervical or vaginal mucopurulent discharge
3.oral temperature >101°F (>38.3°C)
together with investigation findings
4.laboratory evidence of gonorrheal or chlamydial infection.
5.A wet specimen of vaginal fluid is able to detect the presence of concomitant infections ( bacterial vaginosis and trichomoniasis)
6. pelvic ultrasound is a helpful procedure for diagnosing PID.It can check the pelvic area to see whether there is an abscess or enlarged fallopian tubes.
7.laparoscopy is a minor surgical procedure in which a thin, flexible tube with a lighted end in inserted through a cut in the navel area to view the internal pelvic organs and to take specimens for testing.
Other criteria for diagnosing PID include the following:
8.endometrial biopsy with histopathologic evidence of endometritis;
9.transvaginal sonography or magnetic resonance imaging techniques showing thickened, fluid-filled tubes with or without free pelvic fluid or tubo-ovarian complex,
10.doppler studies suggesting pelvic infection
What are the complications of PID?
-----------------------------------------
Prompt and appropriate treatment can help prevent complications of PID.
Without treatment, PID can cause
1. permanent damage to the female reproductive organs.
Infection-causing bacteria can invade the fallopian tubes, damaging the lining of the tubes causing blockage of the fallopian tubes and preventing sperm from fertilising an egg.
2.Infertility also occur when the fallopian tubes are partially blocked or even slightly damaged as therm may find it difficult to reach the egg.
3.ectopic pregnancy may occur when the fertilized egg remains in the partially blocked fallopian tube and begins to grow.
As it grows, an ectopic pregnancy can cause rupture of the fallopian tube resulting in abdominal pain, internal bleeding, and death.
4.chronic pelvic pain that lasts for months or even years due to the inflammation, damage to the pelvic organs, and contraction of the scarred tissues.
5.endometrosis are blood clots in the pelvic region which occurs due to inflammation of the pelvis and can also cause pain during menses.
6. abscess formation in the reproductive organs or pelvis which can spread to the blood and cause septicemia.
What is the treatment for PID?
-------------------------------------
Treatment of PID should be initiated in
1.sexually active young women
2. pelvic or lower abdominal pain,
3. physical examination shows cervical motion tenderness, uterine tenderness or adnexal tenderness.
PID can be treated with several types of antibiotics(eg.clindamycin or metronidazole with doxycycline).
However, antibiotic treatment will not reverse any damage to the reproductive organs. If a woman has pelvic pain and other symptoms of PID, it is important that she seek care immediately.
Prompt antibiotic treatment can prevent severe damage to reproductive organs.
PID is usually treated with at least two antibiotics given by mouth or by injection.
Even if symptoms go away, the woman should finish taking all of the prescribed medicine.
This will help prevent the infection from returning.
Hospitalization to treat PID may be recommended if the woman
(1) is severely ill with nausea, vomiting, and high fever
(2) is pregnant;
(3) does not respond to or cannot take oral medication and needs intravenous antibiotics;
(4) has an abscess in the fallopian tube or ovary (tubo-ovarian abscess).
(5)surgical emergencies (e.g., appendicitis) cannot be excluded;
If symptoms continue or if an abscess does not go away, surgery may be needed.
Complications of PID such as chronic pelvic pain and scarring improve with surgery.
How can PID be prevented?
--------------------------------
1. transmission of STDs can be prevented by abstainance from sexual intercourse,
2. a long-term mutually monogamous relationship with a partner who has been tested and is known to be uninfected can prevent STD.
3.Latex male condoms, when used consistently and correctly, can reduce the transmission of chlamydia and gonorrhea.
4.chlamydia testing of all sexually active women age 25 or younger and of older women with risk factors for chlamydial infections especially those with a new sex partner or multiple sex partners
5.Any genital symptoms such as an unusual sore, discharge with odor, burning during urination, or bleeding between menstrual cycles suggests a STD infection. Early treatment of STDs can prevent PID.
6. Intrauterine contraceptive devices containing levonorgestrel-and copper-containing devices may cause PID and should be removed if antibiotics does not cure the PID.
Thursday, November 22, 2007
A Simple Guide to Bacterial Vaginosis
A Simple Guide to Bacterial Vaginosis
---------------------------------------------
What is bacterial vaginosis?
----------------------------------
Bacterial Vaginosis (BV) is a condition in women where the normal balance of lactobacillus bacteria in the vagina is disrupted and replaced by an overgrowth of high concentrations of anaerobic bacteria (e.g., Prevotella sp. , Mobiluncus sp.), G. vaginalis, and Mycoplasma hominis.
The condition is characterised by vaginal discharge, odor, pain and itching.
Bacterial Vaginosis is the most common vaginal infection in women after puberty.
How is bacterial vaginosis spread?
-------------------------------------------
BV is associated with an imbalance in the lactobacillus bacteria in a woman's vagina. The cause of this imbalance is not known.
Some possible causes of this imbalance are:
1.Having multiple sex partners or a new sex partner
2.Vaginal Douching which alter the pH and bacterial flora of vagina
3.Using an intrauterine device for preventing pregnancy.
Women that have never had sexual intercourse are rarely affected.
What are the symptoms of bacterial vaginosis?
-------------------------------------------------------
Women with typical Bacterial Vaginosis symptoms have:
1.an abnormal vaginal discharge with an unpleasant fish-like odor especially after intercourse.
The discharge is usually greyish, semiadherent, homogeneous.
Sometimes it can be thin,cream to green in colour and frothy.
2.burning sensation during urination
3.itching around the outside of the vagina,
More than 50% women with BV report no symptoms at all.
What are the complications of bacterial vaginosis?
-------------------------------------------------------------
In most cases, there are no complications.
Some serious complications from BV include:
1.pelvic inflammatory disease (PID) especially after surgery like hysterectomy
2.endometritis,
3.increased susceptibility to other STDs, such as chlamydia, gonorrhea and HIV.
4.increased risk for some complications of pregnancy such as ectopic pregnancy and premature births.
How is bacterial vaginosis diagnosed?
---------------------------------------------
1.vagina examination for homogeneous, thin, white discharge that smoothly coats the vaginal walls;
2.laboratory tests on a sample of vaginal fluid:
a.presence of clue cells on microscopic examination;
b.pH of vaginal fluid >4.5;
c.fishy odor of vaginal discharge before or after addition of 1% KOH (the whiff test).
d.Gram stain is used to detect the relative concentration of lactobacilli (long Gram-positive rods), Gram-negative and Gram-variable rods and cocci ( G. vaginalis, Prevotella, Porphyromonas, and peptostreptococci), and curved Gram-negative rods (Mobiluncus) characteristic of BV.
What is the treatment for bacterial vaginosis?
------------------------------------------------------
All women suspected of BV should be treated to avoid such complications as Pelvic Inflammatory Disease.
Treatment is especially important for pregnant women.
All pregnant women who have symptoms of BV should be checked and treated.
BV is treatable with antibiotics :
metronidazole 500 mg orally twice a day for 7 days
OR
Metronidazole gel, 0.75%,5 g intravaginally, once a day for 5 days
OR
Clindamycin 300 mg orally twice a day for 7 days
OR
Clindamycin cream, 2%,5 g intravaginally at bedtime for 7 days
Either can be used with non-pregnant or pregnant women, but the recommended dosages differ.
Patients treated with metronidazole should be advised to avoid consuming alcohol for 24 hours.
BV can recur after treatment.
How can bacterial vaginosis be prevented?
--------------------------------------------------
Since BV is seldom found in women who have never had intercourse.and is associated with having a new sex partner or having multiple sex partners, prevention measures are aimed at sexual transmission:
1. Abstain from sex
2.Do not have multiple sex partners.
3.Do not use vaginal douche.
4.Take all of the medicine prescribed for treatment of BV even if there are no more symptoms.
---------------------------------------------
What is bacterial vaginosis?
----------------------------------
Bacterial Vaginosis (BV) is a condition in women where the normal balance of lactobacillus bacteria in the vagina is disrupted and replaced by an overgrowth of high concentrations of anaerobic bacteria (e.g., Prevotella sp. , Mobiluncus sp.), G. vaginalis, and Mycoplasma hominis.
The condition is characterised by vaginal discharge, odor, pain and itching.
Bacterial Vaginosis is the most common vaginal infection in women after puberty.
How is bacterial vaginosis spread?
-------------------------------------------
BV is associated with an imbalance in the lactobacillus bacteria in a woman's vagina. The cause of this imbalance is not known.
Some possible causes of this imbalance are:
1.Having multiple sex partners or a new sex partner
2.Vaginal Douching which alter the pH and bacterial flora of vagina
3.Using an intrauterine device for preventing pregnancy.
Women that have never had sexual intercourse are rarely affected.
What are the symptoms of bacterial vaginosis?
-------------------------------------------------------
Women with typical Bacterial Vaginosis symptoms have:
1.an abnormal vaginal discharge with an unpleasant fish-like odor especially after intercourse.
The discharge is usually greyish, semiadherent, homogeneous.
Sometimes it can be thin,cream to green in colour and frothy.
2.burning sensation during urination
3.itching around the outside of the vagina,
More than 50% women with BV report no symptoms at all.
What are the complications of bacterial vaginosis?
-------------------------------------------------------------
In most cases, there are no complications.
Some serious complications from BV include:
1.pelvic inflammatory disease (PID) especially after surgery like hysterectomy
2.endometritis,
3.increased susceptibility to other STDs, such as chlamydia, gonorrhea and HIV.
4.increased risk for some complications of pregnancy such as ectopic pregnancy and premature births.
How is bacterial vaginosis diagnosed?
---------------------------------------------
1.vagina examination for homogeneous, thin, white discharge that smoothly coats the vaginal walls;
2.laboratory tests on a sample of vaginal fluid:
a.presence of clue cells on microscopic examination;
b.pH of vaginal fluid >4.5;
c.fishy odor of vaginal discharge before or after addition of 1% KOH (the whiff test).
d.Gram stain is used to detect the relative concentration of lactobacilli (long Gram-positive rods), Gram-negative and Gram-variable rods and cocci ( G. vaginalis, Prevotella, Porphyromonas, and peptostreptococci), and curved Gram-negative rods (Mobiluncus) characteristic of BV.
What is the treatment for bacterial vaginosis?
------------------------------------------------------
All women suspected of BV should be treated to avoid such complications as Pelvic Inflammatory Disease.
Treatment is especially important for pregnant women.
All pregnant women who have symptoms of BV should be checked and treated.
BV is treatable with antibiotics :
metronidazole 500 mg orally twice a day for 7 days
OR
Metronidazole gel, 0.75%,5 g intravaginally, once a day for 5 days
OR
Clindamycin 300 mg orally twice a day for 7 days
OR
Clindamycin cream, 2%,5 g intravaginally at bedtime for 7 days
Either can be used with non-pregnant or pregnant women, but the recommended dosages differ.
Patients treated with metronidazole should be advised to avoid consuming alcohol for 24 hours.
BV can recur after treatment.
How can bacterial vaginosis be prevented?
--------------------------------------------------
Since BV is seldom found in women who have never had intercourse.and is associated with having a new sex partner or having multiple sex partners, prevention measures are aimed at sexual transmission:
1. Abstain from sex
2.Do not have multiple sex partners.
3.Do not use vaginal douche.
4.Take all of the medicine prescribed for treatment of BV even if there are no more symptoms.
Wednesday, November 21, 2007
A Simple Guide to Measles
A Simple Guide to Measles
--------------------------------
What is Measles?
---------------------
Measles is usually a contagious childhood infection caused by the measles virus, one of the paromyxovirus.
It is characterised by typical prodromal symptoms, generalised rash and Koplik's spots in the mouth.
Who is at risk for Measles?
--------------------------------
Any one at any age can contract measles but it usually occurs in childhood.
Spread is usually by infected persons either from mucous discharges from their coughing and sneezing, or from contact with their skin rash,contaminated items and surfaces.
Usually a person is contagious for about two days before symptoms appear, and up to five days after appearance of the rash.
What are the Symptoms of Measles?
-------------------------------------------
There is a prodromal peroid of 5 to 7 days after contact with a infected person.
Early symptoms include:
1.high fever
2.coughing,
3.runny nose, stuffy nose,
4.tiredness,
5.red eyes, tearing. ,
6.Koplik's spots (white spots with a red background , located on the inside of the cheeks near the back molars start to appear 2-4 days after the fever.
7.measles rash usually occurs after the appearance of the Koplik's spots.
The rash is typically red,maculopapular, and starts from behind the ears and face, then spreads downward to the neck, trunk, limbs, and soles. Once it reaches the soles, the rash begins to fade in about four days , first the head and neck, then trunk and limbs. There may be a brownish discoloration in areas of affected skin rashes but this is only temporary.
8. enlarged lymph glands may be felt in the neck and groins
9.inflammation of the eyes (conjunctivitis) with tearing may also occurs.
10. diarrhoea and vomiting may occurs in some patients.
Adults tend to suffer more severe symptoms than children do.
People who have had measles develop a natural immunity and cannot contract it again.
What are the Complications of Measles?
------------------------------------------------
1.Ear infection (Otitis Media) is a common complication of measles.
2.pneumonia in very young children and older patients may be dangerous.
3.encephalitis (brain infection)may ocur in 1 out of 600 patients putting them at risk of suffering seizures, coma or dying.
4.the digestive organs (including the liver),the heart muscle or the kidneys may be damaged in rare cases
A pregnant woman who develops a measles infection has
1.an increased risk of premature labour,
2.miscarriage
3.delivery of a low birth weight baby.
What is the Treatment for Measles?
------------------------------------------
There is no cure for measles.
Treatment is therefore symptomatic.
Fever symptoms are treated with Paracetamol.
Children should not be given aspirin due to the risk of Reye's Syndrome which affects the brain
Itch may be controlled by antihistamines which can also help to relieve the runny nose.
Antibiotics may be given if there is superimposed secondary bacterial infection such as otitis emdia and pneumonia.
Cough mixtures may be given to relieve the cough.
Plenty of bed rest is necessary.
Lots of fluids helps to prevent dehydration.
A cool-mist humidifier to soothe respiratory passages may help.
Most patients recover completely from measles.
Death is extremely rare (one out of every 1000 cases), usually from pneumonia or encephalitis.
How do You prevent Measles?
-------------------------------------
Measles can be prevented with the measles vaccine, which is usually given to children at the age of 15 months as part of the MMR (measles, mumps and rubella) combination.
A second MMR vaccine is now given at the age of 12 years.
--------------------------------
What is Measles?
---------------------
Measles is usually a contagious childhood infection caused by the measles virus, one of the paromyxovirus.
It is characterised by typical prodromal symptoms, generalised rash and Koplik's spots in the mouth.
Who is at risk for Measles?
--------------------------------
Any one at any age can contract measles but it usually occurs in childhood.
Spread is usually by infected persons either from mucous discharges from their coughing and sneezing, or from contact with their skin rash,contaminated items and surfaces.
Usually a person is contagious for about two days before symptoms appear, and up to five days after appearance of the rash.
What are the Symptoms of Measles?
-------------------------------------------
There is a prodromal peroid of 5 to 7 days after contact with a infected person.
Early symptoms include:
1.high fever
2.coughing,
3.runny nose, stuffy nose,
4.tiredness,
5.red eyes, tearing. ,
6.Koplik's spots (white spots with a red background , located on the inside of the cheeks near the back molars start to appear 2-4 days after the fever.
7.measles rash usually occurs after the appearance of the Koplik's spots.
The rash is typically red,maculopapular, and starts from behind the ears and face, then spreads downward to the neck, trunk, limbs, and soles. Once it reaches the soles, the rash begins to fade in about four days , first the head and neck, then trunk and limbs. There may be a brownish discoloration in areas of affected skin rashes but this is only temporary.
8. enlarged lymph glands may be felt in the neck and groins
9.inflammation of the eyes (conjunctivitis) with tearing may also occurs.
10. diarrhoea and vomiting may occurs in some patients.
Adults tend to suffer more severe symptoms than children do.
People who have had measles develop a natural immunity and cannot contract it again.
What are the Complications of Measles?
------------------------------------------------
1.Ear infection (Otitis Media) is a common complication of measles.
2.pneumonia in very young children and older patients may be dangerous.
3.encephalitis (brain infection)may ocur in 1 out of 600 patients putting them at risk of suffering seizures, coma or dying.
4.the digestive organs (including the liver),the heart muscle or the kidneys may be damaged in rare cases
A pregnant woman who develops a measles infection has
1.an increased risk of premature labour,
2.miscarriage
3.delivery of a low birth weight baby.
What is the Treatment for Measles?
------------------------------------------
There is no cure for measles.
Treatment is therefore symptomatic.
Fever symptoms are treated with Paracetamol.
Children should not be given aspirin due to the risk of Reye's Syndrome which affects the brain
Itch may be controlled by antihistamines which can also help to relieve the runny nose.
Antibiotics may be given if there is superimposed secondary bacterial infection such as otitis emdia and pneumonia.
Cough mixtures may be given to relieve the cough.
Plenty of bed rest is necessary.
Lots of fluids helps to prevent dehydration.
A cool-mist humidifier to soothe respiratory passages may help.
Most patients recover completely from measles.
Death is extremely rare (one out of every 1000 cases), usually from pneumonia or encephalitis.
How do You prevent Measles?
-------------------------------------
Measles can be prevented with the measles vaccine, which is usually given to children at the age of 15 months as part of the MMR (measles, mumps and rubella) combination.
A second MMR vaccine is now given at the age of 12 years.
Tuesday, November 20, 2007
A Simple Guide to Hepatitis C
A Simple Guide to Hepatitis C
-----------------------------------
What is Hepatitis C?
------------------------
Hepatitis C is a serious inflammatory liver disease caused by a virus which is called hepatitis C virus (HCV).
Who is at risk of Hepatitis C?
-----------------------------------
Hepatitis C virus infection is one of the most common chronic bloodborne infection.
Persons at risk for infection are:
1. injection-drug users
2. blood transfusions or solid organ transplant recipients before July 1992
3. on long-term dialysis
4. sexual exposure to infected HCV carriers(rare)
What are the symptoms of Hepatitis C?
-----------------------------------------------
Persons who has been newly infected with HCV usually are asymptomatic or have a mild clinical illness:
1.mild fever and bodyaches
2.slight jaundice
3.nausea
4.enlarged liver
How do you diagnose Hepatitis C?
----------------------------------------
A person exposed to Hepatitis C infection can detect HCV RNA in blood within 1-3 weeks.
The time from exposure to antibody to HCV seroconversion(or Anti-HCV) is 8-9 weeks.
Therefore diagnosis can usually be confirmed by :
1.the presence of Anti-HCV in 98% of infected persons within 6 months of exposure.
2.Reverse transcriptase polymerase chain reaction to detect HCV RNA
Chronic HCV infection occurs in 70% of HCV-infected persons.
Two thirds of these have evidence of active liver disease but may not be aware of their infection because they are not clinically ill.
Infected HCV carriers can transmit the illness to others and develop chronic liver diseases for years after infection.
What is the treatment of Hepatitis C?
--------------------------------------------
There is no cure for HCV infections.
Persons found to be anti-HCV positive should be evaluated for presence of
1.active infection,
2.presence or development of Chronic Liver Disease,
3.for possible treatment of HCV.
Combination therapy with interferon and ribavirin may help in treatment of patients with chronic hepatitis C.
What is the Prevention for Hepatitis C?
----------------------------------------------
No vaccine for hepatitis C is available.
Immune globulin is not effective in preventing HCV infection after exposure.
Primary prevention is to reduce or eliminate HCV transmission.
Secondary prevention activities is to reduce liver and other chronic diseases in HCV-infected persons by identifying them and providing appropriate medical management and antiviral therapy.
Persons who test positive for anti-HCV should be provided information regarding
1) how to protect their liver from further harm by avoiding alcohol and taking any new medicines (including OTC and herbals)
2) how to prevent transmission to others
a) not donate blood, body organs, other tissue, or semen;
b) not share any personal items that might have blood on them (e.g., toothbrushes and razors);
c) cover cuts and sores on the skin to keep from spreading infectious blood or secretions
3) the need for medical evaluation including assessment of liver function tests, assessment for severity of liver disease and possible treatment, and determination of the need for hepatitis A and B.
HCV-positive women do not need to avoid pregnancy or breastfeeding.
Regardless of test results, persons who use or inject illegal drugs should be counseled to
1.stop using and injecting drugs;
2.enter a program to eradicate complete substance abuse treatment, including relapse prevention;
3.take the following steps to reduce personal and public health risks, if they continue to inject drugs:
4.never reuse or share syringes, water, or drug preparation equipment;
5. use only syringes obtained from a reliable source (e.g., pharmacies);
6.use a new, sterile syringe to prepare and inject drugs;
7.get vaccinated for hepatitis A and B.
-----------------------------------
What is Hepatitis C?
------------------------
Hepatitis C is a serious inflammatory liver disease caused by a virus which is called hepatitis C virus (HCV).
Who is at risk of Hepatitis C?
-----------------------------------
Hepatitis C virus infection is one of the most common chronic bloodborne infection.
Persons at risk for infection are:
1. injection-drug users
2. blood transfusions or solid organ transplant recipients before July 1992
3. on long-term dialysis
4. sexual exposure to infected HCV carriers(rare)
What are the symptoms of Hepatitis C?
-----------------------------------------------
Persons who has been newly infected with HCV usually are asymptomatic or have a mild clinical illness:
1.mild fever and bodyaches
2.slight jaundice
3.nausea
4.enlarged liver
How do you diagnose Hepatitis C?
----------------------------------------
A person exposed to Hepatitis C infection can detect HCV RNA in blood within 1-3 weeks.
The time from exposure to antibody to HCV seroconversion(or Anti-HCV) is 8-9 weeks.
Therefore diagnosis can usually be confirmed by :
1.the presence of Anti-HCV in 98% of infected persons within 6 months of exposure.
2.Reverse transcriptase polymerase chain reaction to detect HCV RNA
Chronic HCV infection occurs in 70% of HCV-infected persons.
Two thirds of these have evidence of active liver disease but may not be aware of their infection because they are not clinically ill.
Infected HCV carriers can transmit the illness to others and develop chronic liver diseases for years after infection.
What is the treatment of Hepatitis C?
--------------------------------------------
There is no cure for HCV infections.
Persons found to be anti-HCV positive should be evaluated for presence of
1.active infection,
2.presence or development of Chronic Liver Disease,
3.for possible treatment of HCV.
Combination therapy with interferon and ribavirin may help in treatment of patients with chronic hepatitis C.
What is the Prevention for Hepatitis C?
----------------------------------------------
No vaccine for hepatitis C is available.
Immune globulin is not effective in preventing HCV infection after exposure.
Primary prevention is to reduce or eliminate HCV transmission.
Secondary prevention activities is to reduce liver and other chronic diseases in HCV-infected persons by identifying them and providing appropriate medical management and antiviral therapy.
Persons who test positive for anti-HCV should be provided information regarding
1) how to protect their liver from further harm by avoiding alcohol and taking any new medicines (including OTC and herbals)
2) how to prevent transmission to others
a) not donate blood, body organs, other tissue, or semen;
b) not share any personal items that might have blood on them (e.g., toothbrushes and razors);
c) cover cuts and sores on the skin to keep from spreading infectious blood or secretions
3) the need for medical evaluation including assessment of liver function tests, assessment for severity of liver disease and possible treatment, and determination of the need for hepatitis A and B.
HCV-positive women do not need to avoid pregnancy or breastfeeding.
Regardless of test results, persons who use or inject illegal drugs should be counseled to
1.stop using and injecting drugs;
2.enter a program to eradicate complete substance abuse treatment, including relapse prevention;
3.take the following steps to reduce personal and public health risks, if they continue to inject drugs:
4.never reuse or share syringes, water, or drug preparation equipment;
5. use only syringes obtained from a reliable source (e.g., pharmacies);
6.use a new, sterile syringe to prepare and inject drugs;
7.get vaccinated for hepatitis A and B.
Monday, November 19, 2007
A Simple Guide to Lice
A Simple Guide to Lice
---------------------------
What is Lice?
------------------
Lice is a parasite called Pediculosis which can live on your skin.
Whare are the locations of Lice?
-------------------------------------
It can occur at the
1. head or Pediculosis Capitis and
2..body or Pediculosis corporis.
3. pubis or Pediculosis Pubis
Pediculosis Capitis
-----------------------
Pediculosis Capitis (hair lice) causes itchiness of the scalp and produce nits(small ovoid eggs) on the hair shafts.
It is spread by personal contact, combs, hats, caps.
The incidence is high in school children and people with long hair.
Pediculosis corporis
------------------------
Pediculosis corporis (body lice) also causes itchiness of the skin of the body.
It is also spread by personal contact, clothing and is associated with poor personal hygience.
Pediculosis Pubis
---------------------
Pediculosis pubis (pubic lice) usually cause itchiness of the pubic area.
There may be lice or nits on their anogenital hair.
Pediculosis pubis is usually spread by sexual contact.
What are the symptoms of Lice?
--------------------------------------
1. Itchiness of the skin with scratch marks
2. Small red bites.
3. Excoriation of the skin
4. Nits on scalp and pubic hairs
5. Urticaria
6. bacterial infections at sites of bites.
7. lice and eggs sometimes seen on underwear or clothing.
How do you diagnose Lice?
-------------------------------
The lice and nits can be seen with a magnifying glass.
What is the treatment of Lice?
------------------------------------------
There are various topical medications used to treat lice:
Benzyl Benzoate lotion applied to affected areas and washed off after 30 minutes
Permethrin 1% cream rinse applied to affected areas and washed off after 10 minutes
Malathion 0.5% lotion applied for 12 hours and washed off
Resistance to pediculcides is widespread and increasing.
Nits should be removed with a fine comb.
Bedding and clothing should be machine-washed, machine-dried using the heat cycle, and allowed to dry in the sun.
Patients should avoid sexual contact with their sex partner until all have been treated.
All family members should be treated in order to eradicate the lice.
---------------------------
What is Lice?
------------------
Lice is a parasite called Pediculosis which can live on your skin.
Whare are the locations of Lice?
-------------------------------------
It can occur at the
1. head or Pediculosis Capitis and
2..body or Pediculosis corporis.
3. pubis or Pediculosis Pubis
Pediculosis Capitis
-----------------------
Pediculosis Capitis (hair lice) causes itchiness of the scalp and produce nits(small ovoid eggs) on the hair shafts.
It is spread by personal contact, combs, hats, caps.
The incidence is high in school children and people with long hair.
Pediculosis corporis
------------------------
Pediculosis corporis (body lice) also causes itchiness of the skin of the body.
It is also spread by personal contact, clothing and is associated with poor personal hygience.
Pediculosis Pubis
---------------------
Pediculosis pubis (pubic lice) usually cause itchiness of the pubic area.
There may be lice or nits on their anogenital hair.
Pediculosis pubis is usually spread by sexual contact.
What are the symptoms of Lice?
--------------------------------------
1. Itchiness of the skin with scratch marks
2. Small red bites.
3. Excoriation of the skin
4. Nits on scalp and pubic hairs
5. Urticaria
6. bacterial infections at sites of bites.
7. lice and eggs sometimes seen on underwear or clothing.
How do you diagnose Lice?
-------------------------------
The lice and nits can be seen with a magnifying glass.
What is the treatment of Lice?
------------------------------------------
There are various topical medications used to treat lice:
Benzyl Benzoate lotion applied to affected areas and washed off after 30 minutes
Permethrin 1% cream rinse applied to affected areas and washed off after 10 minutes
Malathion 0.5% lotion applied for 12 hours and washed off
Resistance to pediculcides is widespread and increasing.
Nits should be removed with a fine comb.
Bedding and clothing should be machine-washed, machine-dried using the heat cycle, and allowed to dry in the sun.
Patients should avoid sexual contact with their sex partner until all have been treated.
All family members should be treated in order to eradicate the lice.
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