DOC I HAVE DYSENTERY
Dysentery is an acute invasive infection of the lining of the intestines caused by a micro-organism such as bacteria or paraste resulting in leakage of fluid from the cell into the intestine(diarrhea) sometimes with bloody mucus, abdominal pain or vomiting.
The causes of Dysentery are:
Bacteria:
1.Shigella
2.E.Coli
Parasitic:
amebic
Transnission occurs most often by close personal contact through hands or soiled clothing or fecal-oral contamination.
Stools can contain red blood cells and white blood cells.
There may blood in the stools.
The symptoms of Dysentery are:
1. watery diarrhea with blood and mucus
2. cramping abdominal pain
3. fever
4. headache and bodyaches
5. serious fluid loss especially in children
6. loss of appetite and energy
Dysentery is transmitted through:
Dysentery can be highly contagious.
The germs are commonly transmitted by people with unwashed hands.
People can get the germs through close contact with infected individuals by sharing their food, drink, or eating utensils, or by eating food or drinking beverages that are contaminated with the germs.
The diagnosis of Dysentery is made by:
1.Doctors generally diagnose Dysentery based on the symptoms and a physical examination.
2.stool sample to test for microscopic examination and stool culture
Microscopic examination shows the presence of red blood cells and polymorphs white blood cells.
Treatment of Dysentery is by:
1.Because of the excessive fluid loss, correction of fluid and electrolyte balance is the most important part of treatment.
Prompt treatment may be needed to prevent dehydration which is the loss of fluids from the body. Important salts or minerals, known as electrolytes, can also be lost with the fluids. Dehydration can be caused by diarrhea, excessive urination, excessive sweating, or by not drinking enough fluids because of nausea, difficulty swallowing, or loss of appetite.
The symptoms of dehydration are
excessive thirst
dry mouth
little or no urine or dark yellow urine
sunken eyes
severe weakness or lethargy
dizziness or lightheadedness
Mild dehydration can be treated by drinking liquids.
Severe dehydration may require intravenous fluids and hospitalization.
Untreated severe dehydration can be life threatening especially in babies, young children and the elderly.
2.Antibiotics is necessary,the choice of which depends on the sensitivity of bacteria to the antibiotic.
Anti parasitic drug for amebic dysentery is usually metronidazole
3.Relief of symptoms include an antispasmodic drug to stop abdominal cramps, medicine to harden the stools such as kaolin and slow down the intestinal movement (lomotil or loperamide).
The following steps may help relieve the symptoms of Dysentery.
1.Allow your gastrointestinal tract to settle by not eating for a few hours.
2.Sip small amounts of clear liquids or suck on ice chips if vomiting is still a problem.
3.Give infants and children oral rehydration solutions to replace fluids and lost electrolytes.
4.Gradually reintroduce food, starting with bland, easy-to-digest food, like porridge or soups.
5.Avoid dairy products, caffeine, and alcohol until recovery is complete.
6.Get plenty of rest.
Prognosis:
Symptoms usually improve within one to 2 days after the onset of treatment.
Outcome is usually excellent with appropriate treatment.
Prevention of dysentery is by:
1.washing of hands thoroughly for 20 seconds after using the bathroom or changing diapers
2.washing of hands thoroughly for 20 seconds before eating
3.disinfecting contaminated surfaces such as counter tops and baby changing stations
4.Avoid eating or drinking foods or liquids that might be contaminated
5.Avoid raw vegetables or meat
Monday, June 6, 2011
Saturday, June 4, 2011
A Family Doctor's Tale -CONTACT DERMATITIS
DOC I HAVE CONTACT DERMATITIS
Contact Dermatitis is a common skin condition which presents as a erythematous or vesicular rash on face, neck, hands and other areas in contact with external environmental substances.
The cause of Contact Dermatitis is related to the exposure of the skin to the external environmental substances, chemicals or plants.
There may be a latent interval of days or years between first exposure and development of sensitization.
Virtually any substance can cause sensitivity of the epidermis of the skin.
Some possible triggers are:
1.Metals especially nickel from bracelet, pendants, neck chains, or chrome from watches, etc
2.Dyes from comestics,lipstick, clothes, hair dyes
3.Chemicals from perfumes, soaps, shaving cream, antiseptic creams
4.drugs such as penicillin, sulphonamides, tetracycline, neomycin, aspirin, NSAIDs, ointment bases,
5.Plants such as poison ivy, flowers, pollens, primrose just to name a few can cause skin allergy
6.Animals - the fur from animals can cause contact dermatitis
Contact Dermatitis affects both sexes equally.
Symptoms and signs of Contact Dermatitis are:
Typical features of Contact Dermatitis are:
1.vesicular or bubbles in areas most exposed to the external environmental substance
2.erythrematous or red rashes in areas most exposed to direct contact
3.hives or urticaria from direct contact such as pollens
4.weeping eczema in severe cases
Diagnosis:
skin patch tests
Treatment of an Contact Dermatitis treatment routine is:
1. Avoid exposure to causative substance
2.application of nonprescription corticosteroid creams and ointments to reduce inflammation
if the condition persists, worsens, or does not improve satisfactorily.
Hydrocotisone cream and ointment are preferred to prevent side effects such as skin thinning.
3.For severe flare-ups, your doctor may prescribe oral corticosteroids (this treatment is not recommended for long-term use).
4.sedative antihistamines are sometimes used to reduce the itch
Prognosis of Contact Dermatitis:
good to excellent in most cases with avoidance of contact substance
Recurrence is always possible due to recontact or new substance allergy
Prevention of Contact Dermatitis is by:
Contact Dermatitis can usually be avoided with some simple precautions.
1.Avoid contact with the causative environmental substance which has been identified
2.Avoid contact with drugs or cosmetics which can trigger off Contact dermatitis
3.Avoid contact with foods having dyes and preservatives
Contact Dermatitis is a common skin condition which presents as a erythematous or vesicular rash on face, neck, hands and other areas in contact with external environmental substances.
The cause of Contact Dermatitis is related to the exposure of the skin to the external environmental substances, chemicals or plants.
There may be a latent interval of days or years between first exposure and development of sensitization.
Virtually any substance can cause sensitivity of the epidermis of the skin.
Some possible triggers are:
1.Metals especially nickel from bracelet, pendants, neck chains, or chrome from watches, etc
2.Dyes from comestics,lipstick, clothes, hair dyes
3.Chemicals from perfumes, soaps, shaving cream, antiseptic creams
4.drugs such as penicillin, sulphonamides, tetracycline, neomycin, aspirin, NSAIDs, ointment bases,
5.Plants such as poison ivy, flowers, pollens, primrose just to name a few can cause skin allergy
6.Animals - the fur from animals can cause contact dermatitis
Contact Dermatitis affects both sexes equally.
Symptoms and signs of Contact Dermatitis are:
Typical features of Contact Dermatitis are:
1.vesicular or bubbles in areas most exposed to the external environmental substance
2.erythrematous or red rashes in areas most exposed to direct contact
3.hives or urticaria from direct contact such as pollens
4.weeping eczema in severe cases
Diagnosis:
skin patch tests
Treatment of an Contact Dermatitis treatment routine is:
1. Avoid exposure to causative substance
2.application of nonprescription corticosteroid creams and ointments to reduce inflammation
if the condition persists, worsens, or does not improve satisfactorily.
Hydrocotisone cream and ointment are preferred to prevent side effects such as skin thinning.
3.For severe flare-ups, your doctor may prescribe oral corticosteroids (this treatment is not recommended for long-term use).
4.sedative antihistamines are sometimes used to reduce the itch
Prognosis of Contact Dermatitis:
good to excellent in most cases with avoidance of contact substance
Recurrence is always possible due to recontact or new substance allergy
Prevention of Contact Dermatitis is by:
Contact Dermatitis can usually be avoided with some simple precautions.
1.Avoid contact with the causative environmental substance which has been identified
2.Avoid contact with drugs or cosmetics which can trigger off Contact dermatitis
3.Avoid contact with foods having dyes and preservatives
Thursday, June 2, 2011
A Family Doctor's Tale - PHOTO DERMATITIS
DOC I HAVE PHOTO DERMATITIS
Photo Dermatitis is a common skin condition which presents as a erythematous or vesicular rash on face, neck, hands and other areas exposed to sunlight.
The cause of Photo Dermatitis is related to the exposure of the skin to the sun.
However some possible triggers are:
1.Genetic
Genes play a part in Photo Dermatitis as the condition runs in families
2.External causes
Photo sensitivity:certain exogenous sensitizers play a part in the development of Photo Dermatitis.
a.drugs such as phenothiazines, thiazides and tetracycline
b.cosmetic such as lipstick, perfumes, soaps, shaving cream, antiseptic creams, even sun screening agents (especially if they contain coal tar)
c.irritating chemicals which exaggerated the photosensitzing effect of the sun
d.sunburn reaciion which aggarvated the skin to react as rashes.
e.Photo allergic rash which persist for years
f. injury by ultraviolet light
g.feeling too hot and/or sweating will cause an outbreak.
h.Stress can also sometimes aggravate an existing flare-up.
Photo Dermatitis affects both sexes equally.
The symptoms and signs of Photo Dermatitis are:
Typical features of Photo Dermatitis are:
1.vesicular or bubbles in areas most exposed to light
2.erythrematous or red rashes in areas most exposed to light
3.some occurs following severe sunburn
4.some are seasonal with recurrance in early spring and summer
5.actinoid reticuloid skin rash affecting the face and hands are also seen in chronic photo dermatitis patients
Photo Dermatitis is diagnosed by:
1.History and appearance of the rash
2.Photo patch testing
3.Determination of light wavelength causing photo dermatitis
Treatment of an Photo Dermatitis treatment routine is:
1. Avoid ultraviolet light especially long wave ultraviolet light
2. application of lotions or creams to protect the skin against the sun
3.chloroquine sulphate 200mg daily may be useful for some patients over short periods
4.application of nonprescription corticosteroid creams and ointments to reduce inflammation
if the condition persists, worsens, or does not improve satisfactorily.
Hydrocotisone cream and ointment are preferred to prevent side effects such as skin thinning.
5.For severe flare-ups, your doctor may prescribe oral corticosteroids (this treatment is not recommended for long-term use).
6.sedative antihistamines are sometimes used to reduce the itch
Prognosis:
1.good to excellent in most cases with phot toxic eruptions
2.good to fair with photo allergic reactions
3.Some patients reacts persistently to light without exposure to an antigen.
Prevention of Photo Dermatitis is by:
Photo Dermatitis outbreaks can usually be avoided with some simple precautions.
The following suggestions may help to reduce the severity and frequency of flare-ups when exposed to the sun:
1.use sun screen
2.Avoid drugs or cosmetics which can trigger off photo dermatitis
3.Avoid sweating or overheating
4.Reduce stress
5.Avoid harsh soaps, detergents, and solvents
6.Avoid environmental factors that trigger allergies (e.g., pollens, molds, mites, and animal dander)
7.Be aware of any foods that may cause an outbreak and avoid those foods
Photo Dermatitis is a common skin condition which presents as a erythematous or vesicular rash on face, neck, hands and other areas exposed to sunlight.
The cause of Photo Dermatitis is related to the exposure of the skin to the sun.
However some possible triggers are:
1.Genetic
Genes play a part in Photo Dermatitis as the condition runs in families
2.External causes
Photo sensitivity:certain exogenous sensitizers play a part in the development of Photo Dermatitis.
a.drugs such as phenothiazines, thiazides and tetracycline
b.cosmetic such as lipstick, perfumes, soaps, shaving cream, antiseptic creams, even sun screening agents (especially if they contain coal tar)
c.irritating chemicals which exaggerated the photosensitzing effect of the sun
d.sunburn reaciion which aggarvated the skin to react as rashes.
e.Photo allergic rash which persist for years
f. injury by ultraviolet light
g.feeling too hot and/or sweating will cause an outbreak.
h.Stress can also sometimes aggravate an existing flare-up.
Photo Dermatitis affects both sexes equally.
The symptoms and signs of Photo Dermatitis are:
Typical features of Photo Dermatitis are:
1.vesicular or bubbles in areas most exposed to light
2.erythrematous or red rashes in areas most exposed to light
3.some occurs following severe sunburn
4.some are seasonal with recurrance in early spring and summer
5.actinoid reticuloid skin rash affecting the face and hands are also seen in chronic photo dermatitis patients
Photo Dermatitis is diagnosed by:
1.History and appearance of the rash
2.Photo patch testing
3.Determination of light wavelength causing photo dermatitis
Treatment of an Photo Dermatitis treatment routine is:
1. Avoid ultraviolet light especially long wave ultraviolet light
2. application of lotions or creams to protect the skin against the sun
3.chloroquine sulphate 200mg daily may be useful for some patients over short periods
4.application of nonprescription corticosteroid creams and ointments to reduce inflammation
if the condition persists, worsens, or does not improve satisfactorily.
Hydrocotisone cream and ointment are preferred to prevent side effects such as skin thinning.
5.For severe flare-ups, your doctor may prescribe oral corticosteroids (this treatment is not recommended for long-term use).
6.sedative antihistamines are sometimes used to reduce the itch
Prognosis:
1.good to excellent in most cases with phot toxic eruptions
2.good to fair with photo allergic reactions
3.Some patients reacts persistently to light without exposure to an antigen.
Prevention of Photo Dermatitis is by:
Photo Dermatitis outbreaks can usually be avoided with some simple precautions.
The following suggestions may help to reduce the severity and frequency of flare-ups when exposed to the sun:
1.use sun screen
2.Avoid drugs or cosmetics which can trigger off photo dermatitis
3.Avoid sweating or overheating
4.Reduce stress
5.Avoid harsh soaps, detergents, and solvents
6.Avoid environmental factors that trigger allergies (e.g., pollens, molds, mites, and animal dander)
7.Be aware of any foods that may cause an outbreak and avoid those foods
Tuesday, May 31, 2011
A Family Doctor's Tale - ENCEPHALITIS
DOC I HAVE ENCEPHALITIS
Encephalitis is a serious medical disease which causes inflammation and infection of the brain.
The causes of Encephalitis may be divided into:
Infections:
1.viral infections are the most common
(herpes simplex virus, mumps, measles, rubella, chickenpox, West Nile Encephalitis, Japanese Encephalitis, St Lious Encephalitis).
Of these viruses, herpes simplex virus is the most serious and can cause fatality.
2.bacterial infections such as meningoccocus (Neisseria meningitidis) and pneumococcus(Streptococcus pneumoniae) can be serious and fatal in some cases.
Meningococcal Encephalitis can cause outbreaks(spread easily).
3.fungi,
Cryptococcus neoformans is the most common cause of fungal Encephalitis
4.Parasitic
Examples are Toxoplasmosis, malaria, amoeba, Lyme Disease
The symptoms which often defines Encephalitis are:
1.Severe headache
2.Fever
3.Irritabilty
4.Confusion
5.Drowsiness and fatigue
Other symptoms are:
6.seizures and convulsions
7.vomiting
8.hallucinations
9.memory problems
10.tremors
11.weakness of the hands and legs
12.incontinence of urinary and bowel movement
The diagnosis of Encephalitis is made by:
1.Typical symptoms of fever, headache, confusion .
2.Physical examination shows confusion ,drowsiness and signs of neck rigidity
3.blood tests (complete blood count, ESR and blood culture)
4.cerebrospinal fluid analysis (CSF) via lumbar puncture is examined for increased white blood cells and protein content, normal glucose level. Red blood cells may be present if there is bleeding. Sometimes the CSF may show the presence of micro-organisms.
This test should not be done if there is suspected cerebral mass lesion or raised intracranial pressure (head injury, localizing neurological signs, or signs of raised ICP).
5.CT or MRI of the brain and spine with MRI preferred over CT because it can detect more easily areas of cerebral edema,tumors, ischemia, and meningeal inflammation.
The complications of Encephalitis are:
1.Neurological deficits
2.deafness
3.learning disorders in children
4.brain infarction,
5.septic shock,
6.adult respiratory distress syndrome
7.seizures also more in children
8.pneumonia especially in the elderly
The treatment of Encephalitis is:
1.Hospitalisation should be immediate as Encephalitis can be a life threatening condition.
2.Antibiotics such as cephalosporin, ampicillin, chloramphenicol, intravenous vancomycin to be started even before doing lumbar puncture.
Acyclovir may be given for herpes virus infection
High dosages of antifungals may be given for Fungal Encephalitis for a prolonged period of time
3.corticosteroids is useful to reduce swelling and inflammation in the brain
4.Sedatives may be needed for irritabilty and restlessness
5.High-flow oxygen
6.intravenous fluids
The prognosis of Encephalitis is:
This depends on the severity and type of infection.
Viral infections except for herpes simplex usually recover quickly.
Bacterial infections such as meningococcus and pneumonia are more dangerous.
The Preventive measures taken for Encephalitis are:
Vaccinations against Haemophilus influenzae in children and adults has reduced the incidence of this form of meningitis and encephalitis.
Mumps vaccination as part of Measles,mumps and rubella vaccine(MMR) has reduced the incidence of mumps related form of meningitis and encephalitis
Vaccinations against Japanese Encephalitis is given for travelers going to endemic places with Japanese Encephalitis.
Encephalitis is a serious medical disease which causes inflammation and infection of the brain.
The causes of Encephalitis may be divided into:
Infections:
1.viral infections are the most common
(herpes simplex virus, mumps, measles, rubella, chickenpox, West Nile Encephalitis, Japanese Encephalitis, St Lious Encephalitis).
Of these viruses, herpes simplex virus is the most serious and can cause fatality.
2.bacterial infections such as meningoccocus (Neisseria meningitidis) and pneumococcus(Streptococcus pneumoniae) can be serious and fatal in some cases.
Meningococcal Encephalitis can cause outbreaks(spread easily).
3.fungi,
Cryptococcus neoformans is the most common cause of fungal Encephalitis
4.Parasitic
Examples are Toxoplasmosis, malaria, amoeba, Lyme Disease
The symptoms which often defines Encephalitis are:
1.Severe headache
2.Fever
3.Irritabilty
4.Confusion
5.Drowsiness and fatigue
Other symptoms are:
6.seizures and convulsions
7.vomiting
8.hallucinations
9.memory problems
10.tremors
11.weakness of the hands and legs
12.incontinence of urinary and bowel movement
The diagnosis of Encephalitis is made by:
1.Typical symptoms of fever, headache, confusion .
2.Physical examination shows confusion ,drowsiness and signs of neck rigidity
3.blood tests (complete blood count, ESR and blood culture)
4.cerebrospinal fluid analysis (CSF) via lumbar puncture is examined for increased white blood cells and protein content, normal glucose level. Red blood cells may be present if there is bleeding. Sometimes the CSF may show the presence of micro-organisms.
This test should not be done if there is suspected cerebral mass lesion or raised intracranial pressure (head injury, localizing neurological signs, or signs of raised ICP).
5.CT or MRI of the brain and spine with MRI preferred over CT because it can detect more easily areas of cerebral edema,tumors, ischemia, and meningeal inflammation.
The complications of Encephalitis are:
1.Neurological deficits
2.deafness
3.learning disorders in children
4.brain infarction,
5.septic shock,
6.adult respiratory distress syndrome
7.seizures also more in children
8.pneumonia especially in the elderly
The treatment of Encephalitis is:
1.Hospitalisation should be immediate as Encephalitis can be a life threatening condition.
2.Antibiotics such as cephalosporin, ampicillin, chloramphenicol, intravenous vancomycin to be started even before doing lumbar puncture.
Acyclovir may be given for herpes virus infection
High dosages of antifungals may be given for Fungal Encephalitis for a prolonged period of time
3.corticosteroids is useful to reduce swelling and inflammation in the brain
4.Sedatives may be needed for irritabilty and restlessness
5.High-flow oxygen
6.intravenous fluids
The prognosis of Encephalitis is:
This depends on the severity and type of infection.
Viral infections except for herpes simplex usually recover quickly.
Bacterial infections such as meningococcus and pneumonia are more dangerous.
The Preventive measures taken for Encephalitis are:
Vaccinations against Haemophilus influenzae in children and adults has reduced the incidence of this form of meningitis and encephalitis.
Mumps vaccination as part of Measles,mumps and rubella vaccine(MMR) has reduced the incidence of mumps related form of meningitis and encephalitis
Vaccinations against Japanese Encephalitis is given for travelers going to endemic places with Japanese Encephalitis.
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