DOC I HAVE TOOTH DISCOLORATION
Teeth discoloration is seen as teeth that have stained yellow or darker and presents as a blemish on the facial appearance of a person.
It can affect self esteem.
The causes of Tooth Discoloration:
Discoloration can be caused by:
A.External factors stains the outer layer of the tooth and include
1.smoking,
2.beverages such as coffee, wine, cola
3.foods such as apples and potatoes.
B.Internal factors affects the inner structure of the tooth (the dentin) causing it to darken or become yellowish through:
1.excessive exposure to fluoride during early childhood
2.tetracycline antibiotics use during the second half of pregnancy and children 8 years old or younger.
3.tooth injury in a child with damage to the developing permanent tooth.
4.Systemic illness during tooth formation such as hemolytic disease of the newborn
5.Ageing discoloration - the dentin turns yellow naturally with ageing making the teeth look discolored.
6.infection(dental caries) result in greyish discoloration.
7.Dentinogenesis imperfecta - rare condition in which children are born with gray, amber or purple discolorations in the teeth
8.Amelogenesis imperfecta - genetic condition in which enamel formed during tooth development is abnormal and causes discoloration of teeth.
Symptoms include:
1.stains on the enamel such as yellow or brown spots.
2.yellow stains on the teeth from dentin showing through the worn away enamel.
Diagnosis
A dental examination can diagnose tooth discoloration.
Treatment
Treatment depends on the cause of the discoloration and may include.
1.Tooth hygiene -proper tooth brushing and flossing techniques
2.Avoid foods and beverages that can cause stains
3.Microabrasion of the stains on the outer surface of teeth
4.Bonding -tooth can be covered with a color-matched composite bonding material
5.Veneers are color-matched thin ceramic shells that cover the outer surfaces of the teeth.
6.applying a bleaching agent to the enamel of the teeth.
a.Vital bleaching over-the-counter whitening agents or in-office whitening procedures
b.Non-vital bleaching
7..Intrinsic stains that are caused by damage to a nerve or blood vessel in a tooth sometimes can be prevented such as removing the inner part of the tooth (the pulp) followed by non-vital bleaching.
Prevention
With some healthy lifestyle changes, teeth discoloration can be prevented.
1.Heavy coffee drinkers can reduce intake
2.smokers can consider quitting .
3.dental hygiene through regular brushing, flossing or
4.have teeth cleaned by a dentist every 6-12 months.
Prognosis
The prognosis is very good for teeth stains caused by external factors such as smoking, beverages.
Stains caused by internal factors may be harder to remove.
Friday, August 5, 2011
Monday, August 1, 2011
A Family Doctor's Tale - COLIC
DOC MY BABY HAS COLIC
Colic is defined as constant inconsolable crying by a baby of about 2 weeks to 3 month for more than three hours a day, three days a week.
The baby draws up his/her legs as in extreme pain and becomes very red in the face.
This usually starts a few weeks after birth and often improves by age 3 months and ends by age 9 months in 90 percent of cases.
What are the causes of Colic?
-----------------------------------
1.Failure to bring up wind that enters the stomach during feeding or crying with the result gas passes into the small intestine and cause pain and excessive contractions.
2.Hunger may be a cause especially with breatfed babies as the milk may not be sufficient to satisfy the baby's hunger.
3.Allergies or lactose tolerance especially with cow's milk may also be a factor
What are Symptoms of Colic?
----------------------------
Typical symptoms of colic include:
1.Regular crying episodes. A baby who has colic often cries about the same time every day, usually in the late afternoon or evening.
2.Intense crying. Colic crying is often intense. It will be extremely difficult to pacify and comfort the baby.
3.Posture changes include curled up legs with clenched fists and tensed abdominal muscles during colic episodes.
Diagnosis:
A physical examination is performed to identify any possible causes for your baby's distress such as an intestinal obstruction.
Diagnostic tests are usually not required.
Treatment
Colic improves on its own, often by age 3 months.
Prescription medications such as simethicone have not shown to be very useful for colic.
It has been suggested that treatment with probiotics which help maintain the natural balance of "good" bacteria in the digestive tract can soothe colic. More research is awaited to determine the beneficial effects of probiotics on colic.
Tips to soothe your baby during colic include:
1.Feed your baby with frequent small feeds and burp the baby.
2.Offer a pacifier to the baby as sucking is a soothing activity for babies and calms the baby down.
3.Hold your baby close to you as cuddling may help some babies to quieten and calm down.
4.Keep your baby in motion by gently rocking the baby in your arms or in an infant swing. Alternatively you may lay your baby tummy down on your knees and then sway your knees slowly or take a walk with your baby.
5.Sing to your baby to soothe your baby.
Support for the mother
These suggestions may help the mother to cope with the stress.
1.Take a break from care giving by requesting help from your spouse or family.
2.It is all right to express your feelings. It is normal for parents to feel helpless, depressed or angry. Confide in your spouse, partner or friend.
3.Remember that it is temporary and improves as the baby grows older. Colic episodes often improve by age 3 months.
Colic is defined as constant inconsolable crying by a baby of about 2 weeks to 3 month for more than three hours a day, three days a week.
The baby draws up his/her legs as in extreme pain and becomes very red in the face.
This usually starts a few weeks after birth and often improves by age 3 months and ends by age 9 months in 90 percent of cases.
What are the causes of Colic?
-----------------------------------
1.Failure to bring up wind that enters the stomach during feeding or crying with the result gas passes into the small intestine and cause pain and excessive contractions.
2.Hunger may be a cause especially with breatfed babies as the milk may not be sufficient to satisfy the baby's hunger.
3.Allergies or lactose tolerance especially with cow's milk may also be a factor
What are Symptoms of Colic?
----------------------------
Typical symptoms of colic include:
1.Regular crying episodes. A baby who has colic often cries about the same time every day, usually in the late afternoon or evening.
2.Intense crying. Colic crying is often intense. It will be extremely difficult to pacify and comfort the baby.
3.Posture changes include curled up legs with clenched fists and tensed abdominal muscles during colic episodes.
Diagnosis:
A physical examination is performed to identify any possible causes for your baby's distress such as an intestinal obstruction.
Diagnostic tests are usually not required.
Treatment
Colic improves on its own, often by age 3 months.
Prescription medications such as simethicone have not shown to be very useful for colic.
It has been suggested that treatment with probiotics which help maintain the natural balance of "good" bacteria in the digestive tract can soothe colic. More research is awaited to determine the beneficial effects of probiotics on colic.
Tips to soothe your baby during colic include:
1.Feed your baby with frequent small feeds and burp the baby.
2.Offer a pacifier to the baby as sucking is a soothing activity for babies and calms the baby down.
3.Hold your baby close to you as cuddling may help some babies to quieten and calm down.
4.Keep your baby in motion by gently rocking the baby in your arms or in an infant swing. Alternatively you may lay your baby tummy down on your knees and then sway your knees slowly or take a walk with your baby.
5.Sing to your baby to soothe your baby.
Support for the mother
These suggestions may help the mother to cope with the stress.
1.Take a break from care giving by requesting help from your spouse or family.
2.It is all right to express your feelings. It is normal for parents to feel helpless, depressed or angry. Confide in your spouse, partner or friend.
3.Remember that it is temporary and improves as the baby grows older. Colic episodes often improve by age 3 months.
Saturday, July 30, 2011
A Simple Guide to Diarrhea
A Simple Guide to Diarrhea
-------------------------------------
What is Diarrhea?
---------------------------
Diarrhea is a symptom defined as an increase in the volume, water content and frequency of bowel movements.
What are the causes of Diarrhea?
--------------------------------------------
Diarrhea is a symptom of many gastrointestinal disorders:
1.Infections:
Bacterial infections such as:
a.Shigella
b.Salmonella and typhoid
c.cholera
Viral infections such as:
a,enterovirus
b.rotavirus
Protozoan infections such as:
a.amoebic
b.giardia
2.Toxins from bacteria in contaminated food:
a.E.coli food poisoning (enterotoxins)
b.staphaloccal food poisoning (preformed toxins)
3.Antibiotic usage:
pseudomembraous enterocolitis
4.Food Intolerance
a.Lactose or sugar intolerance
b.Gluten sensitive enteropathy:
celiac disease, nontropical sprue
5.Inflammatory diseases of the intestine:
a.crohn's disease or regional ileitis
b.ulcerative colitis
6.Malabsorption syndromes
a.malabsorption of bile acids
b.pancreatic steatorrhea
c.ileal resection
7.Cancers:
a.colon
b.rectal cancers
8.Tumors especially hormonal producing tumors:
a,gastrinoma
b.Zollinger-Ellison syndrome
c.glucaglonoma
d.carcinoid tumors
9.Drug induced:
a.excessive use of laxatives
b.magnesium antacids which absorbs water into intestine
c.stimulant cathartics
10.Rapid intestinal movement:
a.Irritable bowel syndrome
b.resection of bowels in tumors or fistula
c.vagotomy
d.other surgery of intestine
rhea with blood and mucus
How is Diarrhea investigated?
------------------------------------------
1.full investigation of the possible underlying causes
2.Macroscopic and microscopic examination of the stools:
e.g rice water is typical of cholera
3.culture and sensitivity to antibiotic of the stools
4.Full blood count and electrolytes
How is Diarrhea treated?
-------------------------------------
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.Specific treatment if available for underling conditions eg.antibiotic the choice of which depends on the sensitivity of bacteria to the antibiotic.
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 Diarrhea.
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:
depends on the cause.
Usual outcome of acute diarrhea is excellent if treated early.
For chronic diarrhea, the underlying cause must be treated.
Outcome is usually excellent with appropriate treatment.
How is Diarrhea prevented?
----------------------------------------
You can avoid infection by:
1.washing your hands thoroughly for 20 seconds after using the bathroom or changing diapers
2.washing your 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
-------------------------------------
What is Diarrhea?
---------------------------
Diarrhea is a symptom defined as an increase in the volume, water content and frequency of bowel movements.
What are the causes of Diarrhea?
--------------------------------------------
Diarrhea is a symptom of many gastrointestinal disorders:
1.Infections:
Bacterial infections such as:
a.Shigella
b.Salmonella and typhoid
c.cholera
Viral infections such as:
a,enterovirus
b.rotavirus
Protozoan infections such as:
a.amoebic
b.giardia
2.Toxins from bacteria in contaminated food:
a.E.coli food poisoning (enterotoxins)
b.staphaloccal food poisoning (preformed toxins)
3.Antibiotic usage:
pseudomembraous enterocolitis
4.Food Intolerance
a.Lactose or sugar intolerance
b.Gluten sensitive enteropathy:
celiac disease, nontropical sprue
5.Inflammatory diseases of the intestine:
a.crohn's disease or regional ileitis
b.ulcerative colitis
6.Malabsorption syndromes
a.malabsorption of bile acids
b.pancreatic steatorrhea
c.ileal resection
7.Cancers:
a.colon
b.rectal cancers
8.Tumors especially hormonal producing tumors:
a,gastrinoma
b.Zollinger-Ellison syndrome
c.glucaglonoma
d.carcinoid tumors
9.Drug induced:
a.excessive use of laxatives
b.magnesium antacids which absorbs water into intestine
c.stimulant cathartics
10.Rapid intestinal movement:
a.Irritable bowel syndrome
b.resection of bowels in tumors or fistula
c.vagotomy
d.other surgery of intestine
rhea with blood and mucus
How is Diarrhea investigated?
------------------------------------------
1.full investigation of the possible underlying causes
2.Macroscopic and microscopic examination of the stools:
e.g rice water is typical of cholera
3.culture and sensitivity to antibiotic of the stools
4.Full blood count and electrolytes
How is Diarrhea treated?
-------------------------------------
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.Specific treatment if available for underling conditions eg.antibiotic the choice of which depends on the sensitivity of bacteria to the antibiotic.
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 Diarrhea.
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:
depends on the cause.
Usual outcome of acute diarrhea is excellent if treated early.
For chronic diarrhea, the underlying cause must be treated.
Outcome is usually excellent with appropriate treatment.
How is Diarrhea prevented?
----------------------------------------
You can avoid infection by:
1.washing your hands thoroughly for 20 seconds after using the bathroom or changing diapers
2.washing your 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
A Family Doctor's Tale -ENURESIS
DOC MY CHILD HAVE ENURESIS
Bedwetting or functional enuresis is the repeated involuntary voiding of urine during day or night at an age where continence or control of urine is expected.
Bedwetting or functional enuresis is common in children.
Prevalence of bedwetting:
5 years old - 7 per cent for boys and 3 per cent for girls
10 years old -3 per cent for boys and 2 per cent for girls
18 years old -1 per cent for boys and 0 per cent for girls
It usually occurs during non rapid-eye-movement (REM) sleep.
The causes of bedwetting are:
1.family history of bedwetting often present
2.prevalence of emotional and mental disorder greater than in general population such as anxiety or rejection
3.slow physical development,
4.an overproduction of urine at night,
5.a lack of ability to recognize bladder filling when asleep
Symptoms
1.day or night involuntary voiding of urine after the age of 5 years at least twice a month or continuously.
2.In older children more than once a month
3.Sometimes a child develops bedwetting in response to jealousy or reduced attention from parents or caretaker after a new child is born into the family
Complications:
Amount of urinary incontinence is related to effect on the child's emotional or psychological well being:
1.self esteem is affected
2.social ostracism by peers
3.anger at caretakers
4.rejection by caretakers
Diagnosis and treatment
1.an underlying condition such as urinary tract infection, developmental bladder abnormalities or nervous system disorders must be ruled out by tests conducted.
2.A "wait and see" approach is the preferred course of action. Record the days when the child is dry and give a reward as a form of motivation.
3.Regulate the amount of fluid taken before bedtime
4.Patient and family counseling will take out the anxiety and fear of rejection by the child
5.Use of urine sensitive device that detects wetness and activate auditory stimulus can help the child condition the response of waking up before he loses control of his bladder. This method is called behavioral conditioning.
6.Medicine such as antidepressant can help to control bedwetting in children but only as as a short-term measure.
Prognosis:
Fairly good with counseling and motivation
Bedwetting or functional enuresis is the repeated involuntary voiding of urine during day or night at an age where continence or control of urine is expected.
Bedwetting or functional enuresis is common in children.
Prevalence of bedwetting:
5 years old - 7 per cent for boys and 3 per cent for girls
10 years old -3 per cent for boys and 2 per cent for girls
18 years old -1 per cent for boys and 0 per cent for girls
It usually occurs during non rapid-eye-movement (REM) sleep.
The causes of bedwetting are:
1.family history of bedwetting often present
2.prevalence of emotional and mental disorder greater than in general population such as anxiety or rejection
3.slow physical development,
4.an overproduction of urine at night,
5.a lack of ability to recognize bladder filling when asleep
Symptoms
1.day or night involuntary voiding of urine after the age of 5 years at least twice a month or continuously.
2.In older children more than once a month
3.Sometimes a child develops bedwetting in response to jealousy or reduced attention from parents or caretaker after a new child is born into the family
Complications:
Amount of urinary incontinence is related to effect on the child's emotional or psychological well being:
1.self esteem is affected
2.social ostracism by peers
3.anger at caretakers
4.rejection by caretakers
Diagnosis and treatment
1.an underlying condition such as urinary tract infection, developmental bladder abnormalities or nervous system disorders must be ruled out by tests conducted.
2.A "wait and see" approach is the preferred course of action. Record the days when the child is dry and give a reward as a form of motivation.
3.Regulate the amount of fluid taken before bedtime
4.Patient and family counseling will take out the anxiety and fear of rejection by the child
5.Use of urine sensitive device that detects wetness and activate auditory stimulus can help the child condition the response of waking up before he loses control of his bladder. This method is called behavioral conditioning.
6.Medicine such as antidepressant can help to control bedwetting in children but only as as a short-term measure.
Prognosis:
Fairly good with counseling and motivation
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