A Simple Guide to Threadworms

A Simple Guide to Threadworms
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What is Threadworms?
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Threadworms are parasitic worms (also called pinworms) which are found in the intestines of children in undeveloped countries.
It is rare in developed countries because of the modern sanitary conditions and better hygiene.
Several members of the same household may be infested at the same time so all the family should be treated together.
What is the cause of Threadworms infection?
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Threadworms eggs or larva are present on the hands or food prepared by people who has threadworms infestations. When the eggs or larvae are swallowed  they developed into adult worms in the intestines. The adult worms will cling on to the mucosal lining of the intestine and absorb nutrients from the food taken into the intestines by the affected person.
The female worms emerge from the rectum at night to lay their eggs on the skin around the anus.
What are symptoms of Threadworms?
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The main symptoms of Threadworms are
1. Itch in the anal region especialy at night when the worms lay the eggs.
2. Itch in the vulva in girls
3. inflammation of the anus as a result of constant scratching.
4.Rarely tiny white worms can be seen wriggling in the feces.
How is the diagnosis of Threadworms made?
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Doctors generally diagnose Threadworms based on:
1.sticky tape pressed to the anal area in the morning before the patient bathes or go to the toilet will collect the eggs for microscopic examination and confirmation of the presence of threadworms
2.Stool examination and culture
Treatment of threadworm infestation is by the use of anti-parasitic medicine:
1.Zentel or Abendazole 400mg in a single dose
2.Pyrantel pamoate 10mg/kg in a single dose
3.Mebendazole 100mg in a single dose
A single dose will usually cure the patient of threadworms but to prevent re-infection a second dosage is taken 2 weeks later.
All the family members should also be treated.
Prevention is through:
1.good personal hygiene and hand washing
2. good food hygiene
What is the prognosis of Threadworms?
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Prognosis is excellent with treatment.

A Family Doctor's Tale -ECU tendonitis

DOC I HAVE EXTENSOR CARPI ULNARIS TENDONITIS

EXTENSOR CARPI ULNARIS TENDONITIS OR ECU is the inflammation of the tendon sheath of the tendon to the small finger at wrist region.

EXTENSOR CARPI ULNARIS TENDONITIS occur occur as a result of narrowing of the tendon sheath of the thumb and the inflammation of the tendon at the level of the wrist.

When the tendon gets caught in the narrowed sheath, the finger becomes locked in the narrowed tendon sheath resulting in pain and swelling.

Women are affected more than men.

Local causes:
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1.trauma of the tendon of the small finger from repetitive weight bearing of the wrist

2.direct injury on the tendon of the wrist from a direct blow to the hand

3.repetitive use of the wrist on keyboard of computer

4.tenosynovitis(inflammation of the tendon and their synovial sheath)as the tendon becomes swollen in the tendon shift as a result of overusage of the wrist

5.common among young and active especially those who play racket sports and basketball

Symptoms:
The onset is usually spontaneous with gradual increasing pains and tightness of the wrist tendons which causes the patient to seek treatment:

1.swelling and pain of the back of the wrist near the small finger side (opposite De Quarvian's Disease)

2.unable to move wrist  or carry heavy objects

Physical examination
1.tendon nodules in flexor tendon of the small finger at wrist level

2.tenderness on flexion of the wrist

2.diagnosis is confirmed with CAT scan or MRI

Treatment:
1.Rest and splinting of affected finger and wrist

2.wrist exercise usually good.

3.Non-steroidal anti-inflammatory drugs for inflammation and pain

4.Corticosteroid injection to reduce inflammation under the narrowed sheath

5.Surgery as last resort to release the tendon by cutting the top part of the  narrowed inflammed sheath

Complication:
If left untreated. it can lead to the permanent loss of rotation of the wrist

Prognosis :
1.usually good with injection of corticosteroid

2.recurrence may occur after injection in which case surgery should be done

Prevention:
1.Avoid forceful use of the wrist and small finger

2.Avoid repetitive movement of the wrist.

A Family Doctor's Tale - DE QUARVIAN'S DISEASE

DOC I HAVE DE QUERVAIN'S DISEASE

DE QUERVAIN'S DISEASE is the compression of the tendon sheath of one of the two tendons to the thumb at wrist region.

The tendon sheath is a protective cover for the tendon which provides protection for the tendon as it travels across the radius bone especially at the joints.

DE QUERVAIN'S DISEASE occur as a result of narrowing of the tendon sheath of the thumb and the inflammation of the tendon at the level of the wrist.

When the tendon gets caught in the narrowed sheath, the finger becomes locked in the narrowed tendon sheath resulting in pain and swelling

Women are affected more than men.

It is also known as the washer woman's sprain or recently Blackberry thumb after the name of the popular smart  phone because of repetitive movement of the thumb on the keys of the phone.

Causes of De Quarvian's Disease:
1.trauma of the tendon sheath of the thumb from too much stress on their thumb from carrying their newborn child especially first time parents

2.pressure on the tendon sheath from weight of the newborn's head on the wrist while feeding the baby

3.repetitive use of the thumb on keyboard of Blackberry phone

4.tenosynovitis (inflammation of the tendon and their synovial sheath) as the tendon becomes swollen in the tendon shift as a result of over usage of the wrist especially when wringing clothes

5.common among middle-aged, housewives and those who often use their thumbs or wrists

Symptoms:
The onset is usually spontaneous with gradual increasing pains and tightness of the wrist tendons which causes the patient to seek treatment:

1.swelling and pain of the thumb side of the wrist
2.unable to open door, bottle caps or wring clothes

Physical examination
1.tendon nodules in flexor tendon of the thumb at wrist level

2.tenderness on flexion of the thumb

3.diagnosis is confirmed with CAT scan or MRI

Treatment of De Quarvian's Disease:
1.Rest and splinting of affected thumb and wrist

2.wrist exercise usually good.

3.Non-steroidal anti-inflammatory drugs for inflammation and pain

4.Corticosteroid injection to reduce inflammation under the narrowed sheath

5.Surgery as last resort to release the tendon by cutting the top part of the  narrowed inflamed sheath

Complication of De Quarvian's Disease:
If left untreated. it can lead to the permanent loss of the thumb

Prognosis of De Quarvian's Disease:
1.usually good with injection of corticosteroid

2.recurrence may occur after injection in which case surgery should be done

Prevention of De Quarvian's Disease:
1.Avoid forceful use of the wrist and thumb

2.Avoid carrying newborn baby with head on the wrist

3.Avoid repetitive movement of the thumb.

A Family Doctor's Tale - TRIGGER FINGER

DOC I HAVE TRIGGER FINGER

TRIGGER FINGER is the compression of the tendon sheath of one of the tendon to the fingers or thumb(trigger thumb)
The tendon sheath is a protective cover for the tendon which provides protection for the tendon as it travels across the finger's bones especially at the joints.

TRIGGER FINGER occur as a result of narrowing of the tendon sheath and the inflammation of the tendon.

When the tendon gets caught in the sheath, the finger becomes locked in the narrowed tendon sheath until the tendon is freed from the tight area from forced movement of the locked finger using the other hand.

If left untreated an affected finger can become permanently bent inwards.

Women are affected more than men.

Causes of Trigger Finger:
1.trauma of the tendon sheath especially carrying heavy plastic bags and other bags

2.pressure on the tendon sheath from exertion of pressure through use of chopper knife and tools on the tendon sheath

3.repetitive use of the fingers such as computer keyboard or mouse

4.tenosynovitis(inflammation of the tendon and their synovial sheath)as the tendon becomes swollen in the tendon shift preventing movement of finger.

5.common among middle-aged, taxi drivers gripping the wheel for long hours every day, housewifes and those who often use their fingers in a gripping motion.

6.Also common among people who use the computer or mobile phones

Symptoms:
The onset is usually spontaneous with gradual increasing pains and tightness of the finger which causes the patient to seek treatment:

1.Finger is unable to extend after bending.
As you try harder to straighten the finger, it snaps open as the swollen tendon that was restrained is freed suddenly

2.pain at the base of the affected finger on the palm

Physical examination
1.tendon nodules in flexor tendon at metacarpal head that moves with the tendon

2.no active finger flexion

3.finger locks in flexion in active movement;
extension only can be performed passively
slight pain occurs with clicking sound when passively moved

4.diagnosis is confirmed with CAT scan or MRI

Treatment of Trigger Finger:
1.Rest and splinting of affected finger

2.finger exercise usually good.

3.Non-steroidal anti-inflammatory drugs for inflammation and pain

4.Corticosteroid injection to reduce inflammation under the narrowed sheath

5.Surgery as last resort to release the tendon by cutting the top part of the  narrowed inflammed sheath

Prognosis of Trigger Finger:
1.usually good with injection of corticosteroid

2.recurrence may occur after injection in which case surgery should be done

Prevention:
1.Avoid forceful use of the fingers

2.Avoid carrying heavy plastic bags

3.Avoid repetitive movement of the fingers.