Monthly Archives: June 2011 - Page 2

Pelvic Floor Exercises For Men And Women

Pelvic floor exercises, often called as the Kegel exercises (named after the obstetrician who developed them) or pelvic floor muscle training (PFMT) are floor exercises that form one of the preliminary treatments for stress urinary continence (SUI).

The exercises are so designed to make the pelvic floor stronger and to enable the patient to be able to exert control over his/ her pelvic muscles.

The exercises were first certified to be efficient in1998 when a few Norwegian scientists carried out a six month trail on various treatments which could then be used against SUI. Pelvic floor exercises were found be the most efficient among others, namely electrical stimulation, vaginal cones and under conditions of no treatment whatsoever.

The pelvic floor exercises comprise of primarily three stages, which includes:

  • Stage 1: Identifying the correct pelvic muscles
  • Stage 2: Learning how to contract the muscles correctly
  • Stage 3: Using fast and slow contractions

Stage 1: Identifying the correct pelvic muscles

First the correct set of pelvic floor muscles is identified in the patient.

Stage 2: Learning how to contract the muscles correctly

The movement followed is an upward and inward contraction, instead of that downwards.

Stage 3: Using fast and slow contractions

The pelvic muscles of the patient are trained to act as desired through repetition of slow and fast contractions.

Slow contractions

Slow contractions aid in increasing the strength of the pelvic floor, which increases the capacity of the muscles to hold back urine.

Fast contractions

Fast contractions aid the pelvic floor in coping up with the pressure exerted during conditions of fullness of bladder, sneeze, cough, etc.

Pros and Cons of practicing pelvic floor or the Kegel Exercises

The pelvic floor exercises may prove to be advantageous but suffer from limiting factors and setbacks also.

The pros of pelvic floor exercises

Certain advantages of practicing the pelvic floor exercise are:

  • They are simple to learn and practice.
  • They are cheap and do not require purchase of special equipments.
  • They are effective and get working during a short span of time.
  • They can be practiced while the patient is in almost any posture – sitting, standing or lying down.
  • The exercises are simple to retain and remember.
  • The exercises can be practiced without the use of vaginal cones.

The downside of pelvic floor exercises

While the exercises prove to be highly advantageous to the patient, they suffer from a few disadvantages also. Certain known disadvantages of practicing pelvic floor exercises are:

  • The patient gets under an obligation to practice the exercises for the rest of his/ her life as a counter measure for stress urinary continence (SUI).
  • It may take up to 15 weeks for a perceivable relief to be reported by the patient from the disorder.
  • Relief factor relies greatly upon if the exercises are being practiced correctly, by following proper posture and the prescribed regime.

The exercises are best learnt from a continence adviser or a physiotherapist.

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Orchiectomy Procedure Side Effects

Orchiectomy is a procedure in which one or both the male testicles are surgically removed. This procedure is also known as the orchidectomy. When both the testicles are removed, this procedure is known as the bilateral orchiectomy. Also known as castration or emasculation as the male is no longer able to reproduce. The testicles help in producing the testosterone hormone. Hence this procedure aims at the stoppage of the production of this hormone and hence is also a hormonal therapy.

The purpose of an orchiectomy is to treat cancer or to lower the level of testosterone in the body. This is usually done in cases of prostate cancer as it uses testosterone to grow rapidly in the body. This procedure can reduce the pain and causes the tumor to shrink all thought it does not cure prostate cancer.

Orchiectomy is usually done to prevent complications, relieve the symptoms and prolong the survival of patients with prostate cancer. During orchiectomy procedure the penis, the scrotum and the skin pouch that carries the testicles are left intact. This procedure can cause sudden hormonal changes in the body.

This procedure can have the following side effects due to sudden hormonal changes:

-loss of sexual interest

-osteoporosis (porous, weak bones)

-erection problems

-gynecomastia (condition which results in large breast development in men)

-loss of the overall muscle mass of the body

-hot flashes

-weight gain

-sterility

An orchiectomy procedure is indicated when a testicular tumor is suspected. The patient may present with a firm, painless, irregular mass arising from the testicles. To confirm if the mass is cancerous a Doppler ultrasonography of the scrotum should be done.

 

Orchiectomy procedure is generally performed by an urologist. This procedure can be performed under local or general anesthesia. An incision of 4-6 centimeters is taken in the abdomen over the pubic bone area. The testicles are detached from the blood vessels and the spermatic cord (vas deferens). The sac is then sutured back together. This procedure can be done in a short hospital stay or as an outpatient procedure. One can resume regular activities in about 1-2 weeks after the surgery. Full recovery can be expected within 4-5 weeks.

After the surgery to reduce the post operative swelling, ice packs should be applied over the scrotum area for the next 48 hours post surgery. The operation sight should be kept clean and dry all the time. The operation sight should be washed and cleaned properly with a dilute solution of hydrogen peroxide. The doctor may also recommend an antibiotic ointment. The patient should avoid any kind of strenuous activity during the healing period.

Orchiectomy is contraindicated in people suffering from congenital adrenal hyperplasia.

The possible complication of the orchiectomy procedure is post operative bleeding and infection which occurs in rare cases.

The advantage of this procedure is that it is a simple, inexpensive and has few risks involved. This procedure is very effective and the patient often shows rapid relief from cancer symptom.

Some men prefer the use of testicular prosthesis which makes the testicles look as they did before the operative procedure. These are placed inside the scrotum.

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All About Novasure

It is said that one in five women suffer from heavy periods. Novasure is a procedure which can either reduce or stop the heavy period. This procedure takes about 5 minutes. This procedure does not have any hormonal side effects and also is a less invasive procedure.

Novasure is preferred by most women as this procedure does not have any kind of side effects. Yet it is seen to dramatically reduce or stop the menstrual bleeding in about 90% of women. Also since novasure is a quick and a onetime procedure, it is generally preferred by women.

This procedure can be done in a doctor’s clinic without the need for general anesthesia and without taking any incisions. Many patients report with no or a little discomfort after the procedure and normal activities can be resumed within a day.

Novasure is an endometrial ablation procedure. In this procedure, the lining of the uterus which is known as the endometrium is removed. The endometrium is responsible for menstrual bleeding in women. The endometrium can be removed by a quick delivery of radiofrequency energy.

Novasure procedure:

The doctor will slightly open your cervix which is the opening of the uterus into which a slender wand is inserted which is equipped with a triangular mesh.

This mesh then gradually takes the shape of the uterus by expanding.

A radiofrequency is measured precisely which is delivered through the mesh for about 90 seconds.

After this the mesh work is pulled back into the wand and both are removed from the uterus.

Immediately after the procedure is completed, some women may feel mild pain, nausea or vomiting, cramping. Most women get relief within a day and can resume normal day to day activity.

Instructions given by the doctor should be properly followed.

A bloody or a watery discharge is normal after this procedure. This may either occur immediately after the procedure or weeks after the completion of the procedure. This episode may last very briefly or in some cases it may last for months together. This could be intermittent and also could get aggravated by certain activities. This bloody or watery discharge is quite common with any endometrial ablation procedure.

Novasure procedure is recommended for those women who do not want to have any children in the future and who want to stop the heavy menstrual bleeding.

Proper counseling with the doctor should be done before the procedure.

This procedure is not recommended for women who would want to have children in the future or in those who are not sure about wanting children in the future.

Novasure is a procedure which treats the endometrium or the lining of the uterus hence the chances of pregnancy after this procedure are low. However pregnancy is sometimes possible if you are sexually active. But getting pregnant after the novasure procedure can be dangerous to the fetus as well as the mother. This is so because the uterine lining will not be able to properly support the fetus during its development.

Clinical results show that about 95% of women are very satisfied with the results.

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Neuroleptic Malignant Syndrome: Symptoms and Treatment

Neuroleptic malignant syndrome is a rare but a serious condition. This condition represents a neurological emergency in most cases.  This syndrome is characterized by- rigidity, hyperthermia and autonomic dysregulation which can occur as a complication when anti psychotic drugs are used. It occurs in about 0.5 to 1% of people exposed to neuroleptics. There are certain anti psychotic drugs which can cause neuroleptic malignant syndrome such as olanzapine, amisulpride etc.

Clozapine had lesser risk in developing tremors and rigidity. This syndrome has been associated with drugs that lead to decreased dopamine receptor activation.

Neuroleptic malignant syndrome is characterized by a triad of symptoms:

-fever

-rigidity

-cognitive changes

The clinical features of neuroleptic malignant syndrome include the following:

-pallor

-dyspnea

-tremors

-tachycardia

-diaphoresis

-labile blood pressure

-hyperthermia

-lethargy, stupor, coma

-psychomotor agitation

-dysphagia

 

Diagnosis:

There is no such diagnostic test available for the neuroleptic malignant syndrome but testing is crucial in evaluation of patients who are at a risk of developing this syndrome. To confirm the clinical symptoms, laboratory diagnosis is necessary.

The laboratory diagnosis will show an elevated level of serum creatine kinase (ck). In neuroleptic malignant syndrome the ck level may vary from 1000 IU/L to 100,1000IU/L. Normal ck level is seen at the early onset of the syndrome or in conditions when rigidity is not present.

Treatment:

The treatment starts with discontinue of all the antipsychotic drugs. Symptoms of neuroleptic malignant syndrome usually disappear with 2 weeks. If the syndrome is caused by the long acting injections of antipsychotics then the symptoms can last for as long as a month.

In the treatment of this syndrome supportive treatment should be used extensively. These supportive measures are aimed at preventing further complications and maintaining all the organ functions.

-patient should be given proper circulatory and ventilator support as needed.

-antipyretics should be used to control body temperature.

-aggressive fluid resuscitation and alkalization of urine can prevent the occurance of kidney failure.

Electroconvulsive therapy is said to be effective in managing patients with neuroleptic malignant syndrome.

Drug therapies with amantadine, bromocriptine and dantrolene with electroconvulsive therapy are said to be useful in the treatment of this syndrome.

Dantrolene is a sketal muscle relaxant, which is also effective in the treatment of malignant hyperthermia.

Bromocriptine is a dopamine antagonist. It is generally recommended to continue this drug for 10 days post the occurance of the episode and it may then be gradually tapered.

Amantadine is generally used as an alternative to bromocriptine. Amantadine has anticolinergic and dopaminergic effect.

 

Complications:

-renal failure

-cardiac arrest

-respiratory failure

-dehydration

-seizure

-hepatic failure

-infections

-pulmonary embolisms

-uncontrolled psychosis

 

Prognosis:

 

This syndrome shows a mortality rate of 10-20%. Mortality rates are seen more in people who develop severe muscle necrosis which results in rhabdomyolysis.

People who have developed neuroleptic malignant syndrome before are at a higher risk of developing the syndrome again.

If antipsychotic drug therapy is started again within 2 weeks of the occurance of this episode then there is a much higher chance of recurrence of this syndrome.

However 30% will still have recurrence even after 2 weeks from the occurance of the episode.

Most people who have suffered from this syndrome are able to tolerate another antipsychotic drug anytime in the future.

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Neurogenic Bladder Symptoms and Treatment

Neurogenic bladder is a neurological condition which causes the urinary bladder to only partially empty itself during the process of urination. This dysfunction of the urinary bladder is caused due to the failure of the central or the peripheral nervous system involved in the control of micturition.

Causes of Neurogenic Bladder

The nervous system sends messages back and forth to the various organs involved to control the process of micturition. A faulty transmission due a damaged nerve may thus result into incomplete micturition or the condition of a neurogenic bladder.

Diseases of the spinal cord such as Syringomyelia or Hydromyelia, spinal injuries, tumors, diseases of the brain, peripheral nerve diseases and defects of the neural tube are often associated with a neurogenic bladder.

Some common disorders of the central nervous system which may cause the condition of a neurogenic bladder include but may not be limited to:

Failure of the peripheral nerves is also a major cause of the condition of neurogenic bladder among patients worldwide. Some diseases of the peripheral nervous system include:

  • Alcoholic neuropathy
  • Diabetic neuropathy
  • Nerve damage due to pelvic surgery
  • Nerve damage from a herniated disc
  • Vitamin B12 deficiency

Symptoms of Neurogenic Bladder

The condition of neurogenic bladder exhibits varied symptoms depending upon the underlying neurological disorder: While symptoms are vague sometimes and go unnoticed, they may be easily perceivable at others.

Some symptoms of an overactive urinary bladder are:

  • Repeated urination in small amounts
  • Fever
  • Burning sensation during urination
  • Problems in emptying out the bladder completely
  • Loss of bladder control

Certain symptoms of an underactive bladder include:

  • Leakage of urine from the bladder

  • Urinary retention
  • Difficulty in comprehending fullness of bladder

Complications caused by Neurogenic Bladder

Some common complications that accompany a neurogenic bladder are:

  • Skin breakdown and pressure sores due to excessive urine leakage.
  • Kidney damage due to excessive urinary pressure built up due to an over-full bladder.
  • Urinary tract infections.

Treatment of Neurogenic Bladder

A common method practiced in the treatment of the condition of neurogenic bladder is catheterization. Catheterization may be intermittent which involves no surgery or permanent requiring permanently attached appliances, or the creation of a stoma, bypassing the urethra to empty the bladder directly.

Other treatments involve the use of Mitrofanoff mechanisms.

Some other medications prescribed by physicians across the world include:

  • Medicines to relax the bladder like oxybutynin or propantheline, generally recommended for an overactive bladder.
  • Medicines to make certain nerves more active like bethanechol, generally prescribed for an underactive bladder.
  • Medicines to treat infections like antibiotics, if the bladder suffers from urinary tract infections.

At more crucial times, a surgery may be required. Some common surgeries in practice include:

  • Electrical stimulation of the sacral nerve
  • Sling surgery

One may also exercise (Kegel exercises) to strengthen the pelvic floor muscles to relieve the bladder off the symptoms of a neurogenic bladder.

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All About The Myers Briggs Test (MBTI)

The Myers Briggs Test Inventory (MBTI), also called as the Myers Briggs Personality Inventory is a more than just a product from CPP– the test is a powerfully functional, easy to use solution that has aided millions of end users worldwide to understand their inter personal and intra personal relationships. It has also helped business of all types and sizes by attending to their organizational requirements of team buildingleadership and coaching, conflict management, career development and retention by forming a strong foundation for all their training and development initiatives. The test has an established credibility worldwide and is highly reliable – it is backed by insightful reports and a human back-end support team which guides the end user through the entire assessment process. The test can be used individually or in combination with other CPP products.

The Myers-Briggs Test inventory lays down a set of tools and techniques to help a person on an individual level and an organization on a group level understand individual differences by the medium of easy to comprehend graphic descriptions of reported type, preferences and characteristics.

The assessment is interactive, budget friendly, can be attempted online or in paper and pencil, provides the information the end user needs in a user friendly, narrative format, provides for a range of report types to choose from, and results in an in depth exploration of the user and his personality type.

The Myer Briggs Test Inventory is available in the following forms and packages to cater to all dimensions of the end user’s requirements:

MBTI Complete: The MBTI test and an interactive interpretation session in one online package.

MBTI Profile: Budget-friendly computer version of the MBTI Step I assessment.

MBTI Self Scorable: Paper-and-pencil friendly version of the MBTI Step I assessment in a concise booklet.

MBTI Step II Profile: Challenges to explore twenty dimensions of the end user’s four-letter type for a better understanding.

The various reports the end user could choose from include:

MBTI Interpretive Report: Provides for a gist of MBTI results concisely yet completely.

MBTI Interpretive Report for Organizations: Summarizes leadership, communication, and problem-solving styles.

MBTI Team Report: Depicts a group’s type and its related problem-solving and conflict management styles.

MBTI Communication Style Report: Lays down communication pros while offering effective communication tips.

MBTI Decision Making Style Report: Summarizes decision-making strengths, potential drawbacks, and areas for relative development.

MBTI Stress Management Report: Depicts the impact of stress on personality traits and provides tips for utilizing strengths to deal with stress effectively.

MBTI Step II Interpretive Report: A comprehensive report that studies the variation within an end user’s personality type.

Some additional resources offered include:

Introduction to Type Series: For reference purposes to help end users apply their learning.

Type Practitioner Series: The end user can look at expanding his/her knowledge of type theory and its applications with this collection.

Leader’s Resource Guides: Potential leaders could look at expanding their knowledge of type theory and its applications with this resourceful guide.

MBTI Team Building Program

MBTI Conflict Management Program

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Mycoplasma Pneumoniae Symptoms and Treatment

Mycoplasma pneumoniae is a microscopic bacterium of the class Mollicutes and is the cause of a form of human primary, atypical bacterial pneumonia (PAP), or “walking pneumonia” that is related to cold agglutinin disease called the Mycoplasma pneumonia. It is called the “walking pneumonia” as the patient continues to normally walk around and perform his day to day activities even after being affected by the bacterium.

The bacterium has one of the smallest genomes known to mankind, with 816 kilobase pairs, also called as a degenerate genome. It is referred to as a degenerate genome as it lacks the components for producing essential cellular compounds including new purines and pyrimidines and tri-carboxylic acid required to carry to life sustaining activities of the cell. Due to the absence of a self-support system, the bacterium is often called an obligate parasite and is never found free-living.

History

In olden times, Mycoplasma pneumoniae was known as “Eaton’s agent”, and was considered to be a virus rather than a bacterium.

Cell Structure

Unlike its counterparts of the class Mollicutes, the Mycoplasma pneumonia lacks a peptido-glycan cell wall. In contrast, it possesses a cell membrane composed of sterol compounds, quite similar to that of eukaryotic cells. In addition, the plasma membrane is a three-layered structure, often called as the trilaminar unit membrane also. Due to the lack of a cell wall, this bacterium is resistant to the effects of penicillin and other beta-lactam antibiotics which act by disintegrating the cell wall. Certain antibiotics which have exhibited effective activity against this bacterium include certain macrolides (erythromycinazithromycinclarithromycin), fluoroquinolones and their derivatives (ciprofloxacin and levofloxacin) and tetracyclines (doxycycline).

Pathophysiology

Mycoplasma pneumoniae transmits itself through the process of respiratory droplet transmission. It attaches itself to the mucosa of the host organism, and survives by extracting essential nutrients from it. It further grows and reproduces through the process of binary fission (each cell divides itself and its components into two halves giving rise to two new cells). Common breeding sites for the bacterium in the human body include the upper and the lower respiratory tract which become home to diseases like pharyngitisbronchitis and pneumonia later due to the infection caused by the bacterium. The infection so caused is referred to as an atypical pneumonia due to its protracted course and lack of sputum production accompanied by a host of extra-pulmonary symptoms.

The disease so caused by the bacterium can further get complicated by the presence of Stevens-Johnson syndromehemolytic anemiaencephalitis or Guillain-Barré syndrome in the patient’s body.

Infections caused by this particular bacterium can be set apart from other types of pneumonia by the comparatively slow progression of symptoms, a positive blood test after 10 days of infection for cold-hemagglutinins, lack of bacteria in a gram-stained sputum sample, and a lack of growth on blood agar.

Treatment

Certain treatments followed worldwide to deal with the bacterium and the various diseases caused by it include prescribing second generation macrolide antibiotics like erythromycin and doxycycline and second generation quinolones.

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Livedo Reticularis Symptoms And The Treatments

Livedo Reticularis is a common dermatological finding. It is a vascular condition. It appears as a lace like purplish reticular pattern on the skin. It is usually seen on the lower extremities, and may be exacerbated be cold exposure. It is probably caused due to swelling of the medium sized veins in the lower extremities. It may be a normal finding or may be associated with diseases associated with the blood, endocrine system, cardiovascular and autoimmune disorders like lupus, antiphospholipid syndrome or Sneddon’s syndrome. In cases where it occurs as a normal phenomenon, it causes no symptoms and requires no treatment. In some cases however; this condition may be associated with pain, discomfort and ulcer formation on the skin affected. In such cases further evaluation, diagnosis of the underlying disorder and treatment will be required. Livedo Reticularis may occur as a result of side effects of certain drugs such as hydroxyurea.

Causes: A number of conditions may be associated with the appearance of this condition. A few of them are mentioned below:

Sneddon’s syndrome: it is a genetic condition. It is associated with livediod vasculitis and systemic vascular disorders like cerebrovascular accidents commonly known as strokes and hypertension. It is a progressive, non inflammatory arteriopathy leading to skin problems as well as cerebrovascular accidents like transient ischaemic attacks, dementia and stroke.

Cutis marmorata telangiectatica congenita: It is a rare congenital vascular disorder affecting the blood vessels of the skin. Females are more affected than males, and usually observed at birth or shortly thereafter.

Idiopathic livedo reticularis: this is the most common form seen. Idiopathic simply means that the cause is unknown. It is a benign condition and commonly affects females more than males. It is known to worsen in cold climatic conditions and gives rise to a lacy purplish appearance of the skin on the extremities. This is caused due to sluggish blood flow in the veins of the extremities. It is usually asymptomatic. However, in a few cases patients may develop ulceration over the affected skin of the lower extremities. Warm protective clothing and warm applications on the affected area, may improve the condition.

Secondary Livedo Reticularis: Autoimmune disorders affecting the vascular system like: Livediod vasculitis, polyarteritis nodosa, systemic lupus erythematosus, rheumatoid arthritis and dermatomyositis.

Drugs that can cause Livedo Reticularis are amantidine, hydroxyurea etc.

Infections like tuberculosis, syphilis and lyme’s disease also may be associated.

Certain other conditions like Antiphospholipid syndrome it a condition that affects coagulation of blood and causes formation of small blood clots in the arteries and veings.

Hypercalcaemia- which means high blood calcium levels that may get deposited,

Cryoglobulinaemia is a condition in which the blood contains large amounts of cryoglobulins which is a protein that is insoluble at low temperatures.

Arteriosclerosis means thickening and sclerosis of the walls of the arteries.

Polycythaemia rubra vera or thrombocytosis increase the risk of forming thrombi in the blood.

Treatment: Idiopathic Livedo reticularis does not require any treatment. It may improve on warm covering and warm applications to the affected parts. Once established however the discolouration may becomes permanent. When secondary causes are involved, the causes must be identified and treated.

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Legionnaires’ Disease Symptoms And The Treatments

Legionnaires’ disease refers to pneumonia cause by the Legionella species. It was first recognized in 1976 when an outbreak of pneumonia took place at a hotel in Philadelphia during the American Legion Convention. Legionella pneumophila is a bacterium that was isolated from lung specimens from the victims at autopsy. The source of these bacteria is water. It has been isolated in lakes, streams, cooling towers and potable water supply sources. It can survive in refrigerated water samples for years. However once the organism enters the human constructed reservoirs, tanks etc. it grows and multiplies by leaps and bounds. It grows favourably at warm temperatures and in stagnated waters.

Transmission of the organism: There are many ways the organism can be transmitted to humans for example by aerosolization, aspiration and direct instillation into the lungs. However it is unclear whether Legionella enters the lungs via oropharyngeal colonization or directly via the drinking of contaminated water.

Incidence: The incidence of Legionnaires’ disease depends on the degree of contamination of the aquatic reservoir, the immune status of the persons exposed to the infection and the intensity of exposure. Risk factors for suffering from this disease are cigarette smoking, immunocompromised status, chronic lung disease, old age. Hospital acquired pneumonia or community acquired disease may occur and may not bear the typical risk factors mentioned.

Clinical features: Incubation period is 2 to 10 days. Patients present with mild cough which is usually slightly productive, in some cases the sputum may be streaked with blood. Other symptoms are mild fever, headache, malaise, lethargy, anorexia, myalgia and arthralgia. Some patients present with shortness of breath. Gastrointestinal manifestations like diarroea, nausea, vomiting and abdominal pain may be seen. Various neurological abnormalities too may be seen like headache, lethargy or even encephalopathy. On examination the patient is febrile, relative bradycardia may be seen, abdominal tenderness may be generalized or localized. Chest examination reveals rales in the early course of disease and progresses to consolidation.

Diagnosis of Legionnaires’ disease: chest radiographs show pulmonary infiltrates, pleural effusion, consolidation. Nodular opacities seen may show cavitations and quick spread in immunosuppressed cases. In such cases, pulmonary abscesses too may be seen.

Sputum samples obtained by bronchoalveolar lavage or otherwise must be sent for gram staining and culture. In cases of pleural effusion, pleural tapping may be done and DFA staining, culture must be done.

The assay for Legionella soluble antigen in the urine is a rapid and relatively inexpensive test to be performed and is highly specific.

Antibody testing of both acute and convalescent phase sera is necessary. A fourfold rise in the titer is diagnostic of infection.

Treatment: Antibiotics are used for the treatment of Legionella infection. Macrolides like Azithromycin, Clarithromycin, Quinolones like Levofloxacin, Ciprofloxacin, Ofloxacin, Tetracyclines like Doxycycline, Tetracyclines, Minocycline etc.

Prevention: Routine environmental culture of the hospital water supply is recommended as an approach to the prevention of hospital acquired Legionnaires’ disease. Disinfection of the water supply also is effective. Legionella bacteria can be inactivated by UV light.

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Iron Deficiency Anaemia: Symptoms and Treatment

Iron deficiency anaemia is a widespread type of anaemia- a condition which is the result of a dip in the number of red blood cells. In particular, this type of anaemia causes a decrease in the number of red blood cells due to iron loss, inadequate dietary consumption or absorption of iron. When an iron deficiency is present, haemoglobin which is that component of the RBC which contains iron and carries oxygen cannot be formed. This in turn impacts the production of red blood cells as a whole, resulting in the onset of iron deficiency anaemia.

Iron deficiency is the single most common basis for anaemia across the globe, accounting for roughly 50% of all cases. Anaemia builds up gradually once the iron stores present in the body and bone marrow have been depleted. As a rule, women have lesser stores of iron than men as they lose more iron due to menstruation. Thus they are at a higher risk of developing iron deficiency anaemia than males.

Causes

Amongst children this form of anaemia is linked to lead poisoning. Gastro intestinal bleeding which is linked to some forms of cancer and ulcers is considered to be a root cause. Iron deficiency also arises due to a poor diet or a vegetarian one as well. Poor absorption of iron which culminates in the paucity of iron in the body has been found to be rooted in conditions like Celiac disease, Chron’s disease and gastric bypass surgery. Abnormal menstruation (heavy, long and frequent periods) cause enormous iron loss in women making them susceptible to iron deficiency anaemia.

Symptoms

Iron deficiency anaemia is famously associated with paleness; however the following symptoms are also observed in patients:

  • The sclera (white of the eye) assume a bluish tinge
  • Nails become exceedingly brittle
  • Weakness, headaches and tetchiness are commonly observed
  • Breathlessness
  • Pica (an eating disorder) and a loss in appetite is seen, especially in children
  • Mouth ulcers
  • Irregular menstrual cycles (missing periods, unusually heavy flow)
  • Inflammation, infection, or soreness of the tongue

Treatment

Like majority of other ailments, the treatment of this condition also depends on the cause. In case of the cause being poor dietary intake, eating iron rich foods (eggs, fish, meat, poultry, legumes) and taking iron supplements (ferrous sulphate) are commonly prescribed. The supplements can either be given orally or intravenously. Vitamin C supplements may also be recommended as it is an essential component in augmenting haemoglobin production. Individuals who are at a high risk of developing iron deficiency anaemia (elderly, pregnant or breastfeeding women, women of child-bearing age) must take iron supplements as their regular diet does not generally provide the sufficient amount. The hematocrit (percentage of blood volume made up of RBCs) is expected to be normal following about 2 months of iron therapy. However, the course should be continued for 6 – 12 months post this to refill the body’s iron stores in the bone marrow.

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Hydrocele Symptoms And A Look At Surgery

Hydrocele is an abnormal collection of serous fluid in the tunica vaginalis of the testis or within some part of the processus vaginalis. It may be divided into two categories based on the cause: primary or secondary. Primary Hydrocele – the cause is unknown. Secondary Hydrocele – it is secondary to a disease in the testis and or the epididymis.

Primary Hydrocele: there are five known types which are as follows; Vaginal Hydrocele, Encysted Hydrocele of the cord, Infantile Hydrocele, congenital Hydrocele and funicular Hydrocele. Vaginal Hydrocele is the commonest variety. There is no associated disease of the testis or epididymis. The fluid is usually amber in colour. It commonly occurs in middle aged men. It is more common in tropical countries. The patient will complain of a swelling in the scrotum. Slight amount of pain or discomfort may be present. It may be confused with inguinal hernia, haematocele, pyocele, chylocele, filariasis of the scrotum, tumours of the testis. On examination, it is a cystic swelling and is localized only to the scrotum. The testis may be palpated posterior to the vaginal Hydrocele. The most characteristic test is the transillumination test which is always positive as the fluid is clear in a primary Hydrocele.

Complications: Infection, atrophy of the testis, rupture, calcification of the sac, haematocele and hernia of the Hydrocele sac are some of the common complications.

Treatment: Surgical excision is the treatment of choice. In older patients, tapping of the fluid may be done. In infants, it should be left alone as they may disappear spontaneously. However if they persist, surgery might be necessary.

Congenital Hydrocele: In this condition the processus vaginalis remains patent so there is a direct communication of the tunica vaginalis with the peritoneal cavity. The communicating orifice at the deep inguinal ring is too small for the development of a hernia. It is present since birth. When the patient lies horizontal, the Hydrocele vanishes as the fluid drains back into the abdominal cavity. In the erect position it appears again. The swelling is not easily reducible due to narrowness of the deep inguinal ring.

Funicular Hydrocele: It is a condition in which the processus vaginalis remains patent up to the top of the testis where it is shut off from the tunica vaginalis. The swelling is inguinal rather than scrotal. The testis can be felt separately.

Infantile Hydrocele: The tunica vaginalis is continuous with the processus vaginalis which is shut off from the peritoneal cavity at the deep inguinal ring. It forms an inguinoscrotal swelling thus resembling an inguinal hernia. However there is no impulse felt on coughing.

Secondary Hydrocele: It refers to an abnormal collection of fluid into the tunica vaginalis which is associated with diseases of the testis and or the epididymis. Most common causes are acute epididymo-orchitis, chronic epididymo-orchitis, and malignant disease of the testis, trauma, lymphatic obstruction and post herniorrhaphy Hydrocele. It hardly becomes big enough. It is lax and hence palpation of the testis and epididymis is not difficult. In such cases, the cause must be treated in order to get rid of the Hydrocele.

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Hepatitis B Symptoms, Treatment And Vaccine

Hepatitis B virus (HBV) is a DNA virus with a compact genomic structure. The clinical presentation may vary from being asymptomatic and inapparent to fulminant and fatal acute infections on one hand and from subclinical persistent infections to rapidly progressive chronic liver disease with cirrhosis and even hepatocellular carcinoma. It belongs to hepadnaviruses type 1. The envelope protein expressed on the outer surface of the virion is referred to as Hepatitis B surface antigen (HBsAg), this is a product of the S gene of HBV. Another antigen on the surface of the nucleocapsid core is referred to as Hepatitis B Core antigen (HBcAg). A third HBV antigen is Hepatitis Be antigen (HBeAg), it is a product of the C gene of HBV. Within the nucleocapsid core is present a DNA polymerase which directs replication and repair of HBV DNA. HBcAg particles remain in the hepatocyte. Therefore naked core particles do not circulate in the serum.

Diagnosis: The first viral marker detectable in the serum is HBsAg, followed by elevation of serum aminotransferase and clinical symptoms and remains detectable during the entire symptomatic phase of Hepatitis B and beyond. HBsAg becomes undetectable in two months after the onset of jaundice. After HBsAg disappears, anti HBsAg becomes detectable in the serum and remains thus indefinitely. HBcAg is never seen freely in the serum. Anti HBcAg is detectable in the serum one to two weeks after appearance of HBsAg. During the window period between HBsAg disappearance and appearance of anti HBsAg the anti HBcAg is the only serological evidence for detection of HBV infection. IgM anti HBcAg indicates a current or recent acute HBV infection. IgG anti HBcAg indicates an infection in the remote past as well as a chronic HBV infection. In persons who have recovered from Hepatitis B, anti HBs and anti HBc persists indefinitely. HBeAg appears shortly after HBsAG. During this phase there is a high viral replication and detectable levels of HBV DNA. Individuals who remain HBsAg positive for atleast 6 months are considered to HBV carriers. HBeAg is a convenient and readily detectable qualitative marker of HBV replication. HBsAg positive serum containing HBeAg is likely to be highly infectious and to be associated with the presence of HBV DNA. HBeAg appears shortly after HBsAg. During the course of Hepatitis B, HBeAg may disappear and anti HBeAg will appear in the serum. When this happens there is a concurrent decline in the viral load. PCR tests have been developed to measure levels of HBV DNA, called the viral load.

Transmission: It is transmitted mainly through sexual contact, blood transfusions, reuse of contaminated needles and syringes and vertical transmission from mother to child.

Symptoms: It has an incubation period of 4 to 12 weeks. Acute infection begins with lethargy, weakness, loss of appetite, nausea, vomiting, fever, dark coloured urine, jaundice. In most cases it is a self limiting illness. However few patients may progress to development of fulminant disease which proves fatal. Chronic infection may be asymptomatic or may be associated with chronic inflammation of the liver and progress to cirrhosis and finally hepatocellular carcinoma.

Treatment: Acute Hepatitis B infection does not require treatment in most cases as it is self limiting. Only immunocompromised hosts may require antiviral therapy. Chronic carriers require antiviral drugs like interferons, lamivudine, tenofovir, adefovir, entecavir. Treatment may last for 6 months to a year depending on the medication used.

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Essiac Tea – Nature’s Cure

Essiac also known as Essiac tea is a blend or mixture of herbs which is used in alternative medicine for the treatment of cancer and other illnesses. In ancient times it was in use by the Native Americans for treating various illnesses. A Canadian nurse Rene Caisse rediscovered the recipe in 1922. She had observed a case of breast cancer been treated by this remedy. The nurse named the tea thus, as was her last name spelt backwards. She used it to treat many people suffering from cancer. She died in the year 1978. She had also conducted many researches to prove the effectiveness of this remedy. For this she worked at a renowned hospital in Boston. The basic ingredients in this herbal preparation were greater burdock root (Articum lappa), slippery elms inner bark (Ulmus rubra) also known as Ulmus flava, Indian or Turkish Rhubarb (Rheum Officinale) and sheep sorrel (Rumex acetosella). Many of the brands available nowadays contain 4 or 6 or 8 ingredients. Caisse also set up a free cancer clinic in Ontario in order to cure patients suffering from cancer using Essiac. This clinic was in operation from 1934 to around 1942. For more than 50 years until her death in 1978 when she turned 90, she had treated thousands of cancer patients. She treated patients who were written off as terminally ill by famous doctors of those times. She gave the formula for the manufacture of the preparation to Resperin Corporation Ltd. Sometime in the 1970’s in order that the trails may be done on humans and that the drug be officially certified for doing benefit in treatment of terminally ill cancer patients. The company however shut down much before they started the trial of the drug on humans. Later on the formula was sold to Essiac Products Ltd, which currently markets the medicine.

There are reports claiming the use of Essiac tea for general health benefits. Infact it seems to be a panacea for a variety of illnesses, not only cancer. It is used for general wellbeing and detoxification of the body. Some other ailments which can be treated with this tea are depression, mental disorders, stress, jaundice, burns, cough of a long duration, hepatitis, diabetes mellitus, stomach disorders, problems in digestion, acid peptic disease, dyspepsia, skin problems like acne, urticaria, eczema, dermatitis, sores, rashes, bronchial asthma, chronic fatigue syndrome, AIDS, liver disorders, kidney problems, immune system disorders.

Efficiency: As far as the question of is concerned, there is currently not enough evidence to prove or disprove the efficacy of this herbal preparation. Human cancer trials have not been carried out so far to prove its efficacy. The various ingredients used for the preparation of this formula have been individually used since ancient times for the treatment of various illnesses. Rhubarb has shown to contain some antitumour properties; slippery elm inner bark has so far no recorded anti tumour efficacy. Sheep sorrel and burdock have been used since ancient times in the treatment of cancer. But there is not enough evidence to guarantee the treatment of cancer by Essiac.

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Bee Sting Treatment And Home Remedy

A bee’s sting leads to venom being introduced into the victim’s skin through the stinger of the bee. In most cases, it is found that the stinger is left within the skin. It is essential to note that there is no anti venom available for bee sting treatment.  A bee’s sting evokes two broad types of reactions in the sufferer:

  • A localised reaction
  • A systemic allergic reaction

The first is the most common response, which leads to the skin taking on a redden appearance and also being quite painful. In addition, the person may experience swelling or itching. These symptoms are known to subside within a few hours.

If the localised reaction takes on a severe form, namely a large localised reaction, the aforementioned symptoms will persist for a longer period of time (approximately a week) and the skin surrounding the infected area may also be affected.

The second category of reactions causes the entire body to be in distress; it occurs as the body is allergic/extra-sensitive to the venom of the bee. This response is accompanied by nausea, light-headedness, vomiting, and diarrhoea. The victim may also experience hives and swelling in areas of the body which are located away from the site of the sting.

The severe, serious and at times fatal form of an allergic reaction is known as anaphylaxis, and is most observed in individuals who have a history of allergic responses to previous stings. Multiple stings are known to augment the likelihood of anaphylaxis. The onset of the reaction is within an hour (maximum) of the sting. The symptoms of an anaphylactic reaction include difficulty breathing, a drop in blood pressure and other vitals that can culminate in shock. Most bee stings can be treated at home; however systemic allergic reactions require specific bee sting treatment.

Bee sting treatment for a nip with no signs of allergic reactions includes first aid wound care (cleaning with water and antiseptic ointment). The stinger should be removed as early as possible and medication can be taken for the pain, swelling and itchiness (Benadryl, Tylenol, calamine lotion). Applying an ice pack on the area may also provide relief. Treatment for such localised reactions can be given at home itself.

For a systemic allergic reaction, antihistamine or steroids may be administered. An epinephrine injection can also be given. Hospitalisation may be required based on severity of symptoms, where the patient will be kept under observation to rule out a severe reaction.

Bee sting treatment for an anaphylactic reaction must be timely as this is a life-endangering situation. The line of treatment followed generally is a tracheal intubation. Steroid, epinephrine and antihistamine injections are also resorted to. The patient is provided with IV fluids. Close observation perhaps in the intensive care unit is indicated for most victims. Victims are also advised as a part of routine bee sting treatment to get a tetanus immunization shot if the last shot has been given more than 10 years prior.

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Common Low Testosterone Symptoms and Treatment

Like the very name suggests, low testosterone refers to an abnormal fall in the level of testosterone in the human body (in case of both, males and females), the consequences of which affect the body at a cellular, organ, or body-wide (systematic) level.

Testosterone is a steroid hormone produced by the human reproductive system (testes in males and ovaries in females) in large amounts and by the adrenal glands in smaller portions. The hormone serves the following functions in the human body:

Androgenic functions: Forming and maintaining the male sex organs and promoting secondary male sex characteristics in both, males and females.

Anabolic functions: Facilitating muscle growth and bone development.

The production of testosterone is regulated by hormonal signals produced by the pituitary gland and the hypothalamus located in the brain.

The hypothalamus produces the gonadotrophin releasing hormone (GRH), which in turn travels to the pituitary gland further stimulating this gland to release the follicle stimulating hormone (FSH) and luteinizing hormone (LH). These hormones aid in activating the sex organs and subsequently, regulating the testosterone levels in the blood stream.

Causes of Low Testosterone

The causes of low testosterone levels may vary from one patient to another. Yet, some common causes experienced among patients worldwide include, but may not be limited to:

  • A dysfunction on the level of the hypothalamus or the pituitary gland in producing appropriate amounts of LH and FSH to stimulate testosterone production.
  • An abnormal functioning on the level of testosterone producing glands (ovaries or testes).
  • Changes in sex hormone binding globulin (SHBG) may also account for a fall in testosterone levels in the human body.

When the disorder lies in the organs that produce testosterone, it is called a “primary hypogonadism”. In case the problem lies with the pituitary, it is called “secondary hypogonadism”. In the third case, i.e. “tertiary hypogonadism, the dysfunction is thought to be at the level of the hypothalamus.

Some common causes of primary hypogonadism include undescended testicles, injury to the scrotum sac, cancer therapy, aging, mumps orchitis, chromosomal abnormalities, ovarian failure, etc.

Secondary and tertiary hypogonadism may be caused due to tumors, hypothalamus malformations, compromised blood flow, inflammations caused by tuberculosis and sarcoidosis, HIV and AIDS, anabolic steroids, obesity, etc.

Symptoms of Low Testosterone

In males, symptoms of decreased testosterone are poor genital development, lack of sexual maturity, failure of the voice to deepen, poor growth of body hair, enlarged breasts, infertility, erectile dysfunction and osteoporosis.

Hot flashes, irritability, decreased libido, sleep disturbances, loss of body hair and osteoporosis are the symptoms of low testosterone levels in women.

Treatment for Low Testosterone

In men, the testosterone replacement therapy is generally prescribed as an intramuscular injection or as a patch or gel placed on the skin or as putty that is applied to the gums of the mouth.

In women, there are currently no preparations that are FDA approved. Women are usually prescribed small doses of the testosterone replacement therapy.

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Pancreas Cancer: Symptoms and Treatment

Pancreas Cancer or Pancreatic Carcinoma is the presence of cancer (a malignant neoplasm) in the pancreas, a large organ situated in the abdomen, behind the stomach, adjacent to the small intestine (the duodenum) and the bile ducts. The pancreas play an instrumental role in our functioning by producing enzymes and insulin. Enzymes, for their part help in the process of digestion and allow the body to absorb proteins, fats. Insulin, on the other hand, is a hormone that primarily regulates the blood sugar level in the body.

Causes

The exact, specific cause of pancreas cancer continues to evade us, yet correlations have confirmed smokers to be at an increased risk of developing such a condition. Obesity has also been found to be a likely cause. The risk of developing this form of cancer is known to increase with age, and family history of the disease can also play truant. Diabetes mellitus also does not bode well and puts an individual at risk of pancreas cancer. Pancreatic cysts and inflammation are also found to have caused this melanoma.

Symptoms

A tumour thriving in the pancreas may betray no symptoms at first. The symptoms of pancreatic cancer are usually found to be indistinguishable and are often easily explained as being linked to other, less serious medical problems. The absence of overt symptoms leads to delay in diagnosis, as a result of which majority of patients have progressed to the advanced level of pancreas cancer by the time it has been detected.

Some commonly observed early symptoms include:

  • Abdominal pain or discomfort (especially in the upper part)
  • Experiencing pain in the back
  • Loss of weight attributed to loss of appetite, bloating
  • Contracting jaundice
  • Dark-coloured urine and stools
  • Diarrhoea
  • Indigestion
  • Itchiness (Pruritis)
  • Sense of nausea
  • Vomiting
  • Fever and chills
  • Diabetes

Types

Exocrine Tumours

The vast majority of exocrine pancreatic tumours are malignant and approximately 95% of them are found to be adenocarcinoma. These originate either from the ducts of the pancreas or from the cells that produce enzymes. Another face that exocrine tumours can take is Carcinoma of the ampulla of Vater, this generally leads to blockage of the bile duct, accumulation of bile, resulting in jaundice.

Endocrine Tumours

Also called Islet Cell tumours, these are less common and take the form of Insulinomas, Glucagonomas, Gastrinomas, Somatostatinomas.

Treatment

Depending on whether the cancer is localised (confined to the pancreas), locally advanced (involving nearby blood vessels or organs) or metastatic (spread to the body), the treatment of pancreas cancer is determined. Surgery is recommended to the select few with localised cancer, these individuals will be cured if the entire tumour is removed. Chemotherapy and radiation are often administered post surgery to augment the cure rate (adjuvant therapy). For pancreatic cancer that cannot be removed completely with surgery, or locally advanced and metastatic cancer, the chances of finding a cure are bleak. However, chemotherapy and radiation may be recommended to extend life and relieve pain and other symptoms.

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All About Hysteroscopy

Hysteroscopy is a surgical procedure, in which the uterine cavity is inspected by a small telescope. The end of the telescope that is inserted has a camera which captures intrauterine images which in turn is projected on a monitor. This procedure can be used for diagnostic as well as therapeutic purposes. Surgeries can be carried out with the help of the images obtained on the monitor. A hysteroscope is basically an endoscope which is inserted in a sheath that contains inflow and outflow channels which are used for insufflations of the uterine cavity. In addition to this, there may be an operative channel enabling insertion of scissors and biopsy instruments. The uterine cavity needs to be insufflated with a suitable medium in order to be inspected hysteroscopically. Either fluid or carbon dioxide gas can be used to expand the cavity. However carbon dioxide gas is not used routinely as a medium as there is a risk of developing gas embolism.

Fluids like electrolyte solutions – normal saline and lactated Ringer’s solution can be used for insufflations. Electrolyte solutions are good conductors of electricity hence should not be used with electrosurgical devices. Non electrolyte fluids may be used in such cases, but it can increase the risk of hyponatraemia. Solutions like glucose, mannitol, sorbitol, dextran or a mannitol and sorbitol mixture are examples of non electrolyte fluids. If the patient suffers from fructose malabsorption, sorbitol and sorbitol mixtures must be avoided.

Procedure: Hysteroscopy is done in a hospital setup. Patient is put in the lithotomy position. The procedure can be done under general anaesthesia or paracervical block may be used for the procedure. The cervix is dilated first to enable passage of the scope. The scope is introduced with its sheath. The cavity is then insufflated with a suitable medium. The uterus is then inspected for any abnormalities. The procedure is best done just after menstruation as the endometrium is just shed out and is thinned out. Any operative procedure may be carried out through the operative channel. Most commonly carried out procedures are endometrial ablations, resection of an endometrial polyp or resection of a submucosal fibroid.

Indications: It is useful in a number of conditions such as: Endometrial ablation, endometrial polypectomy, removal of impacted intrauterine devices, myomectomy for uterine fibroids, certain congenital malformations of the uterus like septate uterus, evacuation of the retained products of conception, intrauterine adhesions in cases of Ashermann’s syndrome.

Complications: If hysteroscopy is done in cases of endometrial cancers, there may be spread of the cancer cells to other parts. Another common complication of this procedure is perforation of the uterus. The hysteroscope may damage the uterine walls. In some cases it can perforate through the uterus and damage the bowel walls. Bowel wall perforation as well as uterine wall perforation may lead to peritonitis which means infection in the peritoneal cavity. Other complications are cervical lacerations and intrauterine infections and complications due to the medium used for insufflation. Fluid mediums may cause embolism and fluid overload with electrolyte disturbances.

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All About Flea Bites On Humans

 

flea bites on humansThe common fleas that bite humans are the dog and cat fleas (Ctenocephalides species) and the rat flea (Xenopsylla cheopis). Fleas transmit plague, murine typhus, typhus like illness due to Rickettsia felis, the rat and dog tapeworms, and Bartonella henselae. The human flea (Pulex irritans) infests human bedding and furniture but mainly in relatively humid buildings that lack central heating. Those persons who are sensitized develop symptoms such as urticaria, pruritic papules and occasionally vesicles and bacterial super infection at the site of the bite. The rat flea, X. cheopis is the most efficient vector of plague, but other fleas too may transmit the infection X.astia, X brasiliensis and Pulex irritans (human flea). Both sexes of the flea are known to transmit plague. It is a zoonoses and is basically caused by Y. pestis. It is a highly communicable disease. Since ages plague has been a great epidemic threat to nations. Y. pestis is a Gram negative bacillus and is transmitted to man by infected rodents, fleas and case of pneumonic plague itself. Plague is spread by the rat flea which dwells on rats and when such a flea bites a human.

 

Types of plague:  Bubonic plague which is the most common form of plague. The rat flea inoculates bacilli into the human. Symptoms include regional lymphadenopathy, fever and chills, headache, prostration, painful lymphadenitis. Enlarged tender large nodes develop in the groin or axilla or neck. Pneumonic plague is highly infectious and spreads from man to man by droplet infection. Septicaemic plague is rather rare.

 

Flea index: It is useful for measurements of the density of fleas. It is also useful to ensure effectiveness of disinfectant spraying programme. Indices used are:

 

Total flea Index: it is the average number of all species per rat.

 

Cheopis Index: It is the average number of X. cheopis per rat. It is a specific flea index, more significant than the total flea index. If this index is more than one it is an indicator of a potentially explosive situation.

 

Specific percentage of fleas: it is the percentage of different species of fleas that are found on rats.

 

Burrow Index: It is the average number of free living fleas per species per rodent burrow.

 

These indices themselves do not indicate and imminent plague epidemic. They serve a warning that more stringent control measures are necessary to protect human population.

 

Measure to control spread of fleas: The most effective method to decrease the number of human flea bites is to break the chain of transmission from rodent to flea and then to men. This is best done by proper application of an effective insecticide. Proper susceptibility tests must be carried out to decide the most effective insecticide. DDT and BHC dusts containing 10% and 3% of the active ingredient respectively must be used. In areas where resistance to one or both of the insecticides are known, dusts of carbaryl 2% or malathion 5% will be effective. Spraying must be done inside the houses covering the entire floor area, bottoms of all walls up to 3 feet above floor level, back of the doors, roofing of the thatched houses, and crevices of the walls. Within 48 hours of application the flea index should drop down to zero. Only then will the number of human flea bites reduce and so will the spread of illness.

 

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Zinc Deficiency: Symptoms and Treatment

Zinc deficiency (also known as hypozincemia) refers to an insufficient presence of the essential trace element zinc in the human body. Unlike other minerals like iron and calcium whose presence is linked to particular organs, zinc is imperative from the point of view of maintaining a functional immune system, cell reproduction, and also in the reproductive process (fertility and conception). It plays an instrumental role in a large number of metabolic processes; specifically it is used in the production of enzymes. Zinc is perhaps best identified to help in preventing or diminishing the duration of a common cold or upper respiratory infection. Our body soaks up only about 30% of our total intake of zinc and hence the alarming occurrence of zinc deficiency especially amongst population in developing nations is easily explained.

Causes

The presence of some factors and conditions may result in the development of or pre-dispose the individual to develop zinc deficiency. Some high risk groups include vegetarians, elderly and malnourished individuals. Zinc is an element which is mainly got from our diet and these populations are most likely to consume foods which do not provide them with adequate amounts of zinc. In addition, lactating mothers may also develop this condition. This nutritional deficiency is also associated with malabsorption, diarrhoea, diabetes, alcoholism and chronic illnesses of the liver, kidneys. Sickle cell disease, acrodermatitis enteropathica and weight-loss surgery can also lead to hypozincemia.

Symptoms

Zinc deficiency can present itself through a number of symptoms, which broadly affect the immune system and the senses, both of which require this mineral. Patients will require a blood test to link the symptoms and hypozincemia.

  • Losing hair (Alopecia)
  • Diarrhoea
  • Skin lacerations
  • Delayed sexual maturation and underdevelopment of sex organs (hypogonadism)
  • Impaired growth in infants and toddlers
  • Impotence and decreased sexual drive
  • Susceptibility to contracting infections and allergies (weakened immune system)
  • Poor healing of wounds
  • Loss of appetite leading to anorexia
  • White spots, bands, or lines on fingernails
  • Mild anaemia
  • Irregular menstrual cycle
  • Problems associated with senses: loss of taste, smell, vision impairments (commonly night blindness), memory problems, distorted perception.

Treatment

The cause and severity of symptoms determine the treatment course for an individual battling zinc deficiency. The most common way to increase the levels of the mineral in the body is to restructure the patient’s diet to include foods rich in zinc. Zinc is found in foods, such as include red meat poultry, shellfish, oysters, whole grains, beans, buts and fortified cereals. The health care provider may also prescribe zinc supplements especially in case of vegetarians and breast-feeding mothers. The most common recommended zinc intake is 8mg/day for women and 11 mg/day for men. The recommended dosage must be adhered to tenaciously as this mineral may cause toxicity.

If zinc deficiency is diagnosed and treated accurately and swiftly, it has a good prognosis track record and the risk of serious complications such as growth impairment, pre-mature delivery, vulnerability to life-endangering infections can be minimized.

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The Time Tested Grapefruit Diet (Hollywood Diet)

The Grapefruit diet (also known as the Hollywood Diet) is a veteran weight reduction programme which has garnered hoards of followers since its inception in the 1930s. The golden rule of the diet is the inclusion of half a grapefruit in every meal (whole or as a juice). The Grapefruit diet postulates that grapefruit contains a miraculous fat-burning enzyme which will jumpstart your weight loss. Essentially the diet is a high protein and low carbohydrate plan. Dieters are advised to consume their quota of grapefruit with protein rich foods like meat, eggs, pulses etc.

Since the 1930’s we have been introduced many versions of the Hollywood diet over the years. Most off-shoots urge followers to drastically slash their calorie intake; some forms actually border on being unhealthy. The diet claims to help you shed a whooping 10 pounds in a measly 12 day programme. However, it has been found that the poundage lost is basically from fluids and not from fat.

In entirety, the Grapefruit diet is a quick-fix, which helps you knock of the pounds in a massive frenzy but causes you to put them back on in an equal hurry. This weight-loss plan encourages dieters to keep themselves hydrated and consume plenty of black coffee (this again is version specific). Exercise may or may not be a feature of the diet depending on which testament you are following.

The diet puts forth a meal plan on the following lines:

Breakfast: Eggs, bacon, black coffee, half a grapefruit or 8 ounces of grapefruit juice

Lunch: Salad (dressing allowed and encouraged), as much meat as you wish, along with the stipulated amount of the magic fruit

Dinner: Red, green or yellow vegetables (sans starch), salad, all-you-can-eat meat or fish options followed by your trusty grapefruit/juice.

Bedtime snack: A glass of skim milk or tomato juice is included

The Grapefruit diet lays down the following ground rules:

  • To see the diet work wonders, you must stick to the list of recommended foods and beverages
  • Even portion of grapefruit or juice that you take must be devoid of any form of sweetener
  • Followers are allowed to function on an unlimited principle; they can eat the approved menu until they feel full (cannot eat anymore)
  • There are no restrictions on method of cooking; fried food, butter is very much permitted
  • Snacking should be limited to only once in a day (before bed)
  • Stick to the list of suggested foods and do not leave anything out from the meal plan as it is the combination of specific foods with grapefruit that make all the difference

The Grapefruit diet has been severely criticized by nutritionists as no scientific findings have corroborated its claims of grapefruit containing a magic element to facilitate weight loss. It also is not your cup of tea if you are looking for a long term, healthy route to cut down the flab. The plan is restrictive and does nothing to promote good eating behaviour.

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The Common Stomach Ulcer Symptoms

Stomach ulcer, also called as the peptic ulcer disease (PUD) or gastric ulcer is often a small mucosal erosion (equal to or greater than 0.5 cm), that is usually acidic and extremely painful, found in the gastrointestinal tract of the patient. It is on of the most common ulcers of the gastrointestinal tract and is often confused with its counterpart, the duodenal ulcer. Ulcers of the duodenum are called so only if they are found within the first 12 inches of the small intestine, beyond which the ulcer is called as the stomach or the gastric ulcer. While duodenal ulcers are mostly benign, stomach ulcers may become malignant over a period of time.

Some of the common causes of stomach ulcer include the Helicobacter pylori bacterium (a spiral-shaped bacterium that breeds in the stomach) and consumption of certain non- steroidal anti-inflammatory drugs (NSAIDs).

Some common symptoms of stomach ulcer include but are not limited to:

Abdominal Pain: One of the most common symptoms of stomach ulcer is abdominal pain (classically epigastric) with severity relating to ingestion, as the production of gastric acid gets increased as food enters the stomach. The pain is usually felt anywhere from the navel up to the sternum, ranging from a few minutes to several hours.

Abdominal bloating: Again, abdominal bloating is one of the most prevalent symptoms of stomach ulcer, mostly experienced after ingestion. Indigestion and heartburn also accompany abdominal bloating in a lot of cases.

Waterbrash: Waterbrash is a sudden rush of saliva often experienced by patients after an episode of regurgitation to dilute the acid in the esophagus.

Nausea and vomiting: Persistent nausea or vomiting is also considered as a potential indication towards a stomach ulcer.

Loss of appetite: A longer loss of appetite is often treated as a vague symptom for stomach ulcer.

Weight loss: A loss of more than 5 percent of the normal body weight in the course of six months or less is one of the most common symptoms of an ulcer of the stomach.

Hematemesis: Hematemesis or vomiting of blood usually occurs in patients due to a bleeding gastric ulcer or from a damaged esophagus due to persistent vomiting.

Melena: Patients suffering from stomach ulcer may experience tarry, foul-smelling feces due to the removal of hemoglobin in the form of oxidized iron during excretion.

Other than the aforesaid symptoms, heartburn , gastroesophageal reflux disease (GERD) and certain NSAIDs often act as catalysts in the formation of a stomach ulcer. The burning or gnawing feeling in the stomach may last anywhere between thirty minutes to three hours.

The symptoms of stomach ulcer may also vary among patients with the location of the ulcer and the patient’s age. Usually, in cases of children and older patients, the symptoms are vague or absent until complications have arisen.

A person suffering from any of the above stated symptoms must be referred to a gastroenterologist for immediate diagnosis. Stomach ulcers can be temporarily relieved from by consuming antacids.

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Types of Pneumococcal Vaccine

The pneumococcal vaccine is majorly categorised into two types:

  • Pneumococcal Conjugate Vaccine
  • Pneumococcal Polysaccharide Vaccine

Pneumococcal Conjugate Vaccine:

This is a vaccine specifically for infants and toddlers. It prevents the occurrence of pneumococcal disease caused by Streptococcus pneumoniae bacteria, which leads to bacterial meningitis, blood infections and other severe health complications in young children. Moreover, the vaccine obstructs the spread of the disease which is communicable. The risk of contracting a pneumococcal infection is the greatest during the first two years of life. This pneumococcal vaccine provides an infant with a protection period of three years; thus giving them protection when they most need it.

This vaccine is administered routinely to infants below 2 years of age in 4 doses at the age intervals of 2 months, 4 months, 6 months, and 12-15months. It is also given to children falling in the age group of 2-4 years if they are suffering from medical conditions and complication on the lines of

  • Sickle cell disease
  • An injured spleen or absence of spleen
  • Ailments that impair the immune system (HIV/AIDS, cancer, diabetes)
  • Chronic lung or heart disease
  • Children on medication such a chemotherapy, radiation etc which significantly weaken the immune system

This type of pneumococcal vaccine is also essential for children who have been placed in group child care or are of Alaskan or Native American origin. The Pneumococcal Conjugate Vaccine should be avoided by children who have experienced a life-endangering allergic reaction to a prior dose or are allergic to a vaccine constituent.

Pneumococcal Polysaccharide Vaccine:

This type of pneumococcal vaccine is instrumental in preventing infections like pneumonia, meningitis, as well as those infiltrating the blood. This vaccine is falls under the inactivated bacteria category; hence it immunizes you against the bacteria. In effect, the immune system is activated to produce antibodies to counter the bacteria in case of exposure. This reduces the odds of you falling ill from an infection traced to Streptococcus pneumoniae bacteria.

This vaccine is recommended for individuals in the following groups:

  • Adults aged 65 years or older
  • Persons exceeding two years of age classified as high-risk due to:

  1. 1. Occurrence of chronic heart or lung disease which includes diabetes mellitus, congestive heart failure, alcoholism, leak of cerebrospinal fluid, cirrhosis
  2. 2. Presence of spleen dysfunctions like sickle cell disease
  3. 3. Removal of spleen (Splenectomy) or a non-functioning spleen (asplenia)
  4. 4. Leukaemia
  5. 5. Multiple myeloma
  6. 6. Renal failure
  7. 7. Weak immune system (caused due to HIV/AIDS, cancer, organ transplantation)
  8. 8. Medications that deteriorate the immune system such as steroids
  9. 9. Living in nursing homes or a place where people with long-term health conditions reside

10. Alaskan natives and certain American Indian populations

Persons with a track-record of hyper sensitivity to a dosage of this vaccine should refrain from using it. It is generally given as a single dose for most people. It must be noted that the pneumococcal polysaccharide vaccine does not provide protection from pneumococcal disease to persons under the age of 2. The pneumococcal conjugate vaccine is required for this purpose.

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Persistent Cough: Causes and Treatment

Persistent cough or chronic cough is cough that continues and does not resolve. It has to be noted that it is not an ailment in itself but in fact a symptom of a disease or health disorder. Across the globe, a chronic cough is one of the most common reasons to prompt a doctor’s visit. If a chronic cough persists the patient should seek a medical consult. A chest x-ray is generally taken in such cases.

Causes

The most identified cause for a cough is a cold or flu many conditions can lead to chronic cough. Viral infections are the most widespread reason of acute cough, particularly in children. A persistent cough can also be traced back to:

  • Respiratory infections (whopping cough)
  • Asthma
  • Allergic rhinitis
  • Sinus infections
  • Cystic fibrosis
  • Bronchiectasis
  • Gastroesophageal reflux disease (GERD)
  • Post nasal drip
  • Cigarette smoking
  • Pneumonia
  • Certain medications used in treating high blood pressure
  • Lung diseases and tumours (uncommon)
  • Inhalation of foreign objects into lungs (especially in children)
  • Tuberculosis

Treatment

Like many other ailments, the treatment of a persistent cough is determined by its cause. In case of acute cough due to asthma, inhaled steroids and bronchodilators are found to provide relief as they bring the inflammation of airways under control. When GERD is the cause, patient should avoid foods that increase the reflux, refrain from eating before lying down, and taking medicines to reduce the elevated stomach acidity. When chronic cough is rooted in sinus infections and post nasal drip, decongestants like nasal inhalers and sometimes even antibiotics are advised to relieve symptoms of post nasal drip. In case of allergic rhinitis, inhaled steroids are known to do the trick. For pneumonia and bronchitis related cough, antibiotics and analgesics are generally prescribed. Most cases bronchitis found in adults results from a viral infection; hence the line of treatment followed is similar to that of common cold which primarily includes taking rest, fluids, analgesics, humidification, and taking lozenges.

When the cause of persistent cough is not outlined, patients may benefit from over-the-counter cough medicines. Cough suppressants can help treat dry coughs as they decrease the urge to cough, on the other hand, expectorants can take care of coughs that cause mucus and blockage of the respiratory tract. Drinking fluids, especially water may provide a soothing effect. Tea is another drink which is considered very beneficial to keep the throat moist.

Coming from cigarette smoking being its common cause, one of the most widely recommended treatments for chronic cough is restricting or stopping smoking of cigarettes altogether. Since bronchitis and pneumonia are also viral infections, to prevent acute cough, one must maintain a distance from patients suffering from these ailments. Another very universal cure for acute cough is taking vitamin C which is known to help reduce inflammation. To prevent the onset of chronic cough, many professionals are known to also recommend eating a diet rich in fruit.

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Motor Neuron Disease: Symptoms and Treatment

Motor Neuron Disease is a group of neurological disorders. They affect the motor neurons which control the voluntary activities and the movement of the body. It is also called as Lou gehrigs disease.

Motor Neuron disease is classified as follows:

Hereditary

  • Wernig- Hoffman disease (Infantile spinal muscular atrophy)
  • Kugelberg – Welender disease (Adolescent spinal muscular atrophy)
  • Others

Sporadic

  • Amyotrophic lateral sclerosis (most common)
  • Progressive muscular atrophy.
  • Progressive bulbar palsy
  • Primary Lateral sclerosis

Causes:

About 90% of Motor Neuron Disease is sporadic. While 10% are familial or by genetic mutation associated with the disease.  There is loss of motor neurons and gliosis in motor neurons and motor nuclei of brain stem and anterior horn of spinal cord. There is degeneration of corticospinal tract in spinal cord.

The symptoms are usually seen between ages of 50 to 70. There is weakness, wasting, fasciculation, spasticity and stiffness of muscles of arms and legs.

It has insidious onset and steadily progressive course. Widespread fasciculation are common but there is no sensory or bladder involvement. The Four patterns are recognized which later merge with each other.

Progressive Bulbar Palsy is characterized by Dysarthria, Dysphagia and Dysphonia. There is low volume of speech with difficulty in swallowing and horseness. The tongue is characterized by wasting and fasciculation and spasticity of muscles is observed. There is presence of emotional Lability with uncontrolled laughter and crying.

Amyotrophic Lateral Sclerosis (ALS) is characterized by death of nerve cells which can no longer send signals to muscles. They do not affect the senses but affect the bladder and bowel along with ability to think or reason.

Weakness and wasting of small muscles of hands are early signs of ALS. There is difficulty in breathing and swallowing.  Head drops due to weakness of neck muscles. Patient presents with paralysis, speech problems, hoarseness in voice and weight loss.

Progressive Muscular atrophy the occurrence ratio Male: Female is 5:1. There is involvement of only lower motor neurons. The early sign is foot drop which unilateral but as the disease progress it is bilateral. The later manifestations include wasting and weakness of hands. The deep tendon reflexes are lost or are totally absent.

Primary Lateral Disease is a rare form of Motor Neuron Disease, the features of which are restricted to upper motor neurons. There is progressive tetraparesis with terminal pseudo bulbar palsy.

Diagnosis of Motor Neuron Disease is done by Blood tests, Electromyography (EMG), Nerve conduction velocity, Magnetic Resonance Imaging (MRI) of spine, Assessing the thyroid functions. The other investigations include Lumbar puncture and Tran cranial Magnetic Stimulation.

Treatment: There is no as such cure for Motor Neuron Disease but the drug riluzole, a sodium channel blocker, can be used which blocks the effects of neurotransmitter Glutamate and extends the life span of the affected patients. The treatment emphasizes on relief of symptoms associated with the disease.

Walking aids, wheel chair and Physiotherapy are other treatment methods for Motor Neuron Disease.

The patients of Motor neuron disease at their last stage present with Anarthria which is severe dysarthria resulting in speechlessness, Aphagia and widespread limb weakness with full consciousness. Death occurs from Pneumonia or Respiratory failure. The usual duration of survival in bulbar palsy is about 2 years, ALS is 4-5 years while PMA is 8-10 years.

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Mitochondrial Diseases Symptoms and Treatment

Mitochondrial diseases are a set of chronic, clinically heterogeneous, genetic diseases caused due to the malfunctioning of the mitochondria (the mitochondria of the cell fail to produce enough energy for cell functioning), the “powerhouses” of the cells that make up the human body. Mitochondria form the key part of all the various cells of the human body except for the blood cells. Mitochondria function by converting the energy of the ingested food into ATP (Adinosine Tri Phosphate) which aids in powering all cellular functions. While some mitochondrial diseases may only affect a single organ, some may leave an adverse affect on multiple organs or organ systems.

Genetics or mutations, acquired or inherited in the mitochondrial DNA (mtDNA) trigger mitochondrial diseases. These mitochondrial DNA mutations occur due to a low mutation rate capability of the mtDNA.

Unlike nuclear DNA, Mitochondrial DNA are strictly inherited from the mother and each mitochondrion typically contains multiple mtDNA. During cell division, each mitochondrial DNA divides itself into two new mitochondria which undergo further division. Even a few defective mtDNA copies can thus trigger a mitochondrial disease.

Classical mitochondrial diseases are usually caused by genetic anomalies or mitochondrial respiratory pathway deficits and occur in a subset of patients with autism. Mitochondrial diseases can also be the outcome of an artificially acquired mitochondrial dysfunction caused due to the adverse effects of drugsinfections or due to other environmental causes.

Symptoms of Mitochondrial Diseases

Depending upon the area in which the cells are affected, symptoms may vary including loss of motor control, gastro-intestinal disorders and swallowing difficulties, poor growth, liver disease, cardiac disease, diabetes, muscle weakness and pain, respiratory complications, seizures, lactic acidosis, developmental delays visual/hearing problems, and susceptibility to infection. Following are some more symptoms that are experienced by patients suffering from mitochondrial diseases worldwide:

Encephalopathy (seizures, developmental delay or regression, myoclonus, movement disorders, complicated migraine, stroke)

Neuropathy

Cardiac conduction defects or cardiomyopathy

Hearing Deficits

Short Stature

Disorders of extra-occular muscles (ptosis, acquired strabismus and ophthalmoplegia)

Diabetes

Renal tubular disease

Visual Loss (retinitis pigmentosa, optic atrophy)

Lactic Acidosis

Other disorders caused by malfunctioning of the mitochondria include poor growth, loss of muscular coordination, muscle weakness, visual and aural disorders, learning disabilities, mental retardation, cardiac, liver and kidney diseases, gastrointestinal and respiratory disorders, neurological problems, autonomic dysfunction and dementia.

Diseases of the mitochondria cause the heaviest damage to the cells of organs and organelles like that of the brain, heart, liver, skeletal muscles, kidney and the endocrine and respiratory systems. Some common mitochondrial diseases include but are not limited to anemiadementiahypertensionlymphomaretinopathy, dystonia, dyskinesias, chorea and neuro-developmental disorders.

Treatments for Mitochondrial Diseases

Treatment options for mitochondrial diseases are currently very limited with only membrane penetrating anti-oxidants, spindle transfer and vitamins being frequently prescribed.

Spindle transfer is where nuclear DNA is transferred from a defective mitochondrion cell to another healthy cell.

The subject of treatment of diseases caused due a dysfunction of the mitochondria is a subject of research under progress. It is being researched by doctors worldwide.

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