Types of Abscesses

The type of Abscess depends on the area where the Abscess is formed. The common ones include:

• Anal Abscess
• Breast Abscess
• Dental Abscess
• Gluteal Abscess
• Ischiorectal Abscess
• Perianal Abscess
• Perineal Abscess
• Periodontal Abscess
• Perirectal Abscess
• Pilonidal Abscess
• Tooth Abscess

Signs and symptoms

• Redness and swelling
• Tenderness
• Fever and chills
• Loss of function of affected body part
• In the case of a deep skin Abscess, high temperature, pain in the affected area, and general weakness can help to identify the Abscess.

Causes

An Abscess develops when the bacteria invade the sebaceous or sweat glands, and hair follicles, or enter through the cuts, incisions, or punctures of the skin - leading to inflammatory responses.

Abscess also develops after a surgical procedure. Internal Abscesses develop as a complication of the existing condition. For example, there may be a chance of development of Abscess due to Appendicitis.

Risk factors

The factors that increase your risk of developing Abscess include:

Intravenous drug use - Through frequent penetration of the needle, there will be skin damage leading to an increased risk of infections.

High Blood Sugar levels – People with Diabetes or who have a diet rich in sugars are more prone to infections.

Weak Immune System – The Immune System may weaken because of other illnesses or the use of immunosuppressive drugs increasing the risk of infections.

When to seek medical advice?

Usually, most Abscesses will heal within two weeks. Uncomplicated skin Abscesses shrink and drain by applying heat with the help of a warm compress. Do not squeeze or puncture an Abscess as it can make the infection deeper and thus worsen the condition.

Consult a doctor in the following situations:

• If the Abscess is larger than 1cm
• If the Abscess fails to heal
• If you have an underlying disease condition such as HIV, Cancer, or peripheral vascular disease
• If you are a drug abuser
• If you are on Steroid Therapy, Chemotherapy, or Immunosuppressive Therapy
• If you are pregnant
• If you have recurrent Abscesses
• If your body temperature is 100.4 F or higher

Diagnosis

Your doctor will review your medical history and ask for information about the time of onset of Abscess, Allergies, use of prescription and non-prescription medicines, and co-existing conditions.

Depending on the location and extent of the Abscess, your doctor may recommend blood tests, wound culture tests, or imaging studies.

Abscess is structurally similar to Cysts and boils. Cysts are painless unless they are irritated by rupture and they usually resolve on their own, unlike Abscess. Boils and Carbuncles are types of Abscesses that involve hair follicles.

Treatment

The standard therapy is incision and drainage of the Abscess. Your doctor will numb the area by administering local Anaesthesia and applying the antiseptic lotion on the affected area. Then the Abscess is cut open to drain the pus and debris. After draining, the wound is left open for one or two days. Later, the wound is dressed with a bandage. The pain subsides as the Abscess heals.

Antibiotics are prescribed to patients with severe Abscesses such as an Abscess on the face, the presence of more than one Abscess, and a compromised Immune System. Dicloxacillin or cephalexin are commonly prescribed antibiotics.

Self-Management

To prevent the development of new or recurrent Abscess:

• Examine your skin regularly, particularly high-risk areas for any minor cuts.
• Clean the cuts and scrapes thoroughly and apply an antibacterial ointment.
• Perform home care carefully as per your doctor’s instructions. Report immediately if there is any illness, fever, increased pain, redness or swelling.
• If you are Diabetic, follow your Diabetes treatment plan without failing to control your blood glucose levels.

Causes

Anaplasmosis is transmitted to humans by tick bites mostly from the species of western black-legged tick (Ixodes pacificus) and black-legged tick (Ixodes scapularis). To spread the bacteria, the tick must be attached to a person for at least 12 to 24 hours. In rare conditions, Anaplasmosis can be transmitted through blood transfusions.

Symptoms

The Anaplasmosis symptoms vary widely from person to person. The onset of symptoms is after one week of the tick bite. The most common symptoms of Anaplasmosis are listed below:

• Fever
• Headache
• Muscle pain
• Malaise
• Chills
• Nausea / Abdominal pain
• Cough
• Confusion
• Change in mental status
• Unintentional weight loss
• Loss of appetite

Rarely rashes can also occur with Anaplasmosis

Diagnosis

If you suspect a tick bite, you must immediately contact a doctor for evaluation of infection and treatment. The diagnosis involves the following:

• Physical examination
• History of any exposure to black-legged ticks
• Blood tests

Your doctor may also recommend a blood smear test to determine the individual microcolonies of A. phagocytophilium in the blood. A polymerase chain reaction test is the only test that confirms the diagnosis.

Treatment

The treatment should not be delayed if Anaplasmosis is suspected, as it is one of the most deadly diseases. If it is not treated immediately after diagnosis, it may lead to fatal outcomes.

Doxycycline is considered to be the first-line therapy for Anaplasmosis treatment. The use of other classes of antibiotics is known to cause severe complications and may also result in rickettsial infections. So, the treatment should be based on the symptoms and should begin before confirming the diagnosis.

If the symptoms do not subside with Doxycycline Therapy, then your condition might not be due to Anaplasmosis. In the case of pregnancy, doxycycline treatment for Anaplasmosis may result in threatening allergies. Therefore, an alternative drug should be used. For that, rifampicin is considered to be the most effective drug for treating Anaplasmosis in pregnant women.

Warning signs of Anorexia

The signs and symptoms of Anorexia Nervosa include:

• Extreme loss of weight with less intake and compulsive exercise
• Perception of being over-weight and in bad shape
• Fear of gaining weight
• Dry, pale and yellow skin with thin hair
• Cold or swollen hands and feet, weak bones and fatigue
• Low Blood Pressure and rhythm disturbances in the Heart
• Poor concentration and memory
• Refusal to eat in public
• Self-induced vomiting or purging
• Use of diet pills or pills that increase urination
• Secondary amenorrhea

Anorexia is a potential cause of many problems like growth arrest, excessive hair fall, and malnutrition. It may lead to weak and brittle bones and problems in the Heart, Thyroid, and Kidneys. Infertility is the most feared consequence. Repeated vomiting of the acidic content from the Stomach can cause tooth decay. Depression, mood swings, decreased mental abilities and suicidal thoughts are the dreaded psychological consequences. Anorexia Nervosa is a serious disorder and can cause death in 10% of cases.

Treating Anorexia Nervosa

Treatment of Anorexia is challenging. The patient has to be made to realize that she or he is suffering from the disorder. Anorexia Nervosa treatment begins with counseling and the first goal is to help the patient gain weight. The doctor may help the patient to follow an eating schedule, decrease physical exercises and increase social activity. Rarely, hospitalization may be required if there are medical complications. If the patient has severe mood problems, medicines like antidepressants, anti-anxiety drugs and mood stabilizers may be needed.

Anorexia Nervosa and Bulimia

Both Anorexia and Bulimia are eating disorders. Both share similarities in that the patient fears weight gain and has a distorted perception of weight and shape. Unlike Anorexia, Bulimia is characterized by excessive eating. Such people adopt irrational methods after eating like using laxatives to purge or mechanically stimulating the throat to cause vomiting. Some may use enemas or pills to stimulate urination. They are involved in heavy exercising and avoid socializing to escape eating. People with Bulimia may be either normal or more in weight than the underweight people with Anorexia. Binging and purging are regular features of Bulimia and the frequency of such practice may be at least twice a week and prevalent for at least three months.

Seek help

Family and friends should support the anorexic patient. A comfortable time and place should be chosen to talk to the patient. Conflicts should be avoided. No blame, shame, guilt or fear should be thrown on the affected person. Help the patient meet the stress in life. Offer moral support. Participate in healthy eating. Offer simple solutions to all situations and persuade them to consult a therapist for help. Offer patient hearing and supportive concern. Let them know you care.

Love yourself!

Anorexia Nervosa is a dreadful disorder, especially among young women who are too inclined to keep themselves in the best shape. It is treatable but may return. Weight management is an elaborate and long affair. Patience, support, positive attitude and sensitivity can go a long way to fight this disorder. Help yourself and help others to eat healthy, and maintain a good body weight.

Symptoms

Symptoms usually begin four to nine days after you start taking antibiotic medication. Diarrhoea is the most common symptom of AAD. You may suffer from loose stools or more frequent Bowel movements. In some cases, after finishing your antibiotic treatment, Clostridium Difficile, a toxin-producing bacterium causes antibiotic-associated colitis (inflammation of the colon). This is due to the imbalance of the type of bacteria in your Intestinal Tract.

In such conditions, you may experience:

• Foul smelling Diarrhoea
• Abdominal cramps
• Nausea and vomiting
• Low-grade fever
• Loss of appetite
• Pus or blood in the stools

Antibiotic-associated Diarrhoea often begins about a week after you start taking an antibiotic. Sometimes, Diarrhoea and other symptoms don’t appear until days or weeks after you have finished antibiotics treatment.

Causes

The exact cause of AAD is still not known. It is believed to be developed when antimicrobial medications upset the balance of “good” and “bad” bacteria in your Gastrointestinal Tract. AAD is also caused by bacteria called Clostridium Difficile, which rapidly grows and releases toxins that damage the Intestinal wall. Many people get this infection after a prolonged stay in a hospital or nursing facility.

Almost all antibiotics can cause AAD, but cephalosporins, penicillins, fluoroquinolones, and clindamycin are the most commonly involved antibiotics.

AAD can occur in anyone who takes antibiotics, but the risk increases if you:

• Are over the age of 65
• Have had surgery on the Intestinal Tract
• Have taken antibiotics for an extended period
• Have taken more than one antibiotic medication

Complications

Dehydration (loss of fluids and electrolytes) is the most common complication. If you do not treat the condition in the early stages, it may become severe and can be life-threatening. You may have a dry mouth, intense thirst, little or no urination, and weakness. Other complications include:

• Bowel perforation- A hole in the Bowel lining
• Toxic megacolon- A severe condition that leads to Bowels being unable to expel gases
• Death

Diagnosis

In most cases, the doctor diagnoses AAD based on your symptoms, history of antibiotic treatment and the results of physical examination. The diagnosis helps to decide the treatment for Diarrhoea. The doctor would perform an endoscopy to confirm the disease by taking a sample from your intestinal tract using an endoscope which is a thin flexible tube with a fiber-optic video camera that is passed down your throat, into your esophagus and Stomach.

Treatment for Antibiotic-induced Diarrhoea

Treatment for AAD depends on the severity of your signs and symptoms. Mild to moderate AAD can be managed by following these tips.

• Drink plenty of fluids such as oral rehydration fluids, fruit juices, soft drinks, and sports drinks to replace the lost body water or overcome rehydration.
• Avoid milk and milk foods, fibre-rich foods such as corn and bran and foods containing wheat flour as it may trigger a Bowel movement.

If you have more severe Diarrhoea or C. difficile infection, then your doctor may ask you to discontinue the antibiotic and replace it with other antibiotics with a lower risk of inducing Diarrhoea.

Nearly 22% of patients with C. difficile-associated AAD have managed the clinical signs and symptoms just within 3 days of drug withdrawal.

Your doctor may recommend a faecal transplant if the symptoms persist. In this technique, fresh stool from the donor is mixed and blended with a salt solution to make the slurry. This is passed through gauze to remove undigested food particles and is transferred into the recipient’s intestine through a colonoscopy or an enema.

If the patient develops serious complications like developing a hole or leak, then the doctor would recommend emergency surgery to remove the affected portion of the colon.

When to seek medical advice?

Report to your health care professional if you are taking any antibiotics and experience symptoms like:

• More than five stools per day
• High volume or watery Diarrhoea
• Fever
• Abdominal pain
• Blood or pus in the stool

Prevention

The key measure for preventing AAD is to limit antibiotic use. Take antibiotics only when your doctor suggests and take them exactly as prescribed. Remember!!! Don’t stop the antibiotic medication without consulting your doctor. If you have C. difficile-related Diarrhoea, maintain good hygiene conditions like using gloves, and washing hands to prevent transmission and dissemination of bacteria.

Causes

The problems associated with any component of the back may lead to back pain. The pain may be acute (sudden pain and lasts for less than six weeks) or chronic (lasts for more than three months). The common causes of back pain are listed below:

• Muscle strain: Repeated lifting of something improperly or lifting too heavy weights may strain the muscles of the back. Constant strain on your back may result in muscle spasms.
• Structural problems: The structural problems that lead to back pain involve:

1. Ruptured discs – These discs cushion each vertebra present in the spine. If there is a rupture in the disc, then the nerves are pressurized leading to back pain.
2. Bulging discs – The bulged discs apply more pressure on the nerves leading to back pain.
3. Sciatica – The compression of the spinal nerve by the Herniated Disc may result in lower back pain.
4. Abnormal curvature of the spine – Conditions such as Scoliosis and Kyphosis involves curve in the spine leading to back pain.
5. Osteoporosis – If the spinal vertebrae become brittle and porous, then it may lead to back pain and may result in compression fractures.

• Day-to-day activities: The activities you do in your everyday life such as bending awkwardly, pushing or pulling something, standing for a longer duration, twisting, and overstretching may cause back pain.

Symptoms

The primary symptom of back pain is an ache or persistent pain in your back. The other symptoms include:

• Muscle pain
• Shooting or stabbing pain
• Pain radiating to the buttocks and the legs
• Limited flexibility of the back

Risk factors

The factors that increase your risk of developing back pain include the following:

• Age: The risk of back pain increases as you get older, and it is more common in people aged 30 to 40 years.
• Physical inactivity: A sedentary lifestyle or physical inactivity makes your bones and muscles rigid leading to pain.
• Smoking: The habit of smoking prevents enough nutrients reaching from the discs and weakens them. This results in back pain.
• Medical conditions: Certain medical conditions such as cauda equina syndrome, Cancer of the spine, infection of the spine, sleep disorders, Shingles, and other infections such as pelvic inflammatory diseases and Kidney infections result in back pain.

Complications

Prolonged back pain can lead to the following complications:

• Weight gain: Due to the restriction in the activities and movement in a person with back pain, there is an increased risk of weight gain.
• Disability: Back pain is one common cause of absence from work due to the person’s disability.
• Nerve damage: Back pain resulting from a Herniated Disc can result in nerve damage. This can lead to numbness of the legs and severe shooting pain in the back of the legs.
• Depression: If the back pain lasts for several days, it can lead to depression of the person due to a disruption in the sleeping, and eating patterns, and a loss of motility.

Diagnosis

Your doctor diagnoses the back pain by assessing your ability to sit, stand, and walk. A pain assessment is also performed where you will be asked to rate your severity of pain on a scale of zero to ten. This helps your doctor to determine the origin of pain and also the presence of muscle spasms. Sometimes, to rule out other causative factors, your doctor may suggest any of the following tests:

• X-ray: The X-ray helps to determine the proper alignment of your bones and also conditions such as Arthritis or broken bones.
• Magnetic Resonance Imaging (MRI) Scan: The MRI Scan is beneficial to obtain more detailed images of the structures in the back. This scan reveals the presence of any Herniated Disc or other conditions related to muscles, bones, nerves, tendons, and ligaments.
• Blood tests: Blood tests are performed to determine the presence of any infection that is leading to back pain.

If your doctor suspects Bone Tumours, Osteoporosis, or Spinal Stenosis, then bone scans and nerve studies are suggested.

Treatment

In the majority of individuals, back pain resolves itself without any medical help. Depending on the type, whether acute or chronic back pain, your doctor might prescribe the following:

Medication

• Over-the-counter analgesics: Drugs such as acetaminophen and aspirin might relieve acute back pain. If these drugs do not relieve the pain, then your doctor may suggest nonsteroidal anti-inflammatory drugs such as ibuprofen, ketoprofen, and naproxen.
• Topical analgesics: Certain topical analgesics that include creams and ointments are applied to the skin over the site of pain.
• Injections: Your doctor may prescribe steroid or anaesthetic injections to reduce your pain.
• Muscle relaxants, anti-depressants, and narcotics may be given in rare conditions.

Surgery

Your doctor may recommend surgery only if you suffer from chronic back pain which was not relieved by any other therapy. You may require surgery if you have a Herniated Disc, Spinal Stenosis, Vertebral Fractures, or Degenerative Disk Disease.

Complementary and Alternative Therapy

Several Alternative Therapies may resolve your back pain, and those include Chiropractic, Osteopathy, Shiatsu, and Acupressure.

• An Osteopath treats and strengthens your musculoskeletal framework with drug-free non-invasive manual medicine.
• A Chiropractor focuses on neuromuscular causes and relieves your back pain.

Breast Cyst Aspiration

Breast Cyst Aspiration is a procedure in which the doctor removes the fluid from the Breast Cyst by using a small needle. Breast Cyst Aspiration aims to confirm the diagnosis and drain the fluid from the Cyst.

The lump in your Breast may cause pain and you may worry whether it is because of Breast Cancer. Breast Aspiration helps your doctor to find out whether the lump in your Breast is a Tumour or Cyst. Breast Aspiration provides the results immediately so that you do not have to wait for specific tests to be carried out.

Breast Cyst Aspiration Procedure

Before the Cyst aspiration, your doctor may conduct an ultrasound procedure to have a better picture of your lump. Then your doctor may cause numbness of the skin of your Breast by giving local anaesthesia (medicine causing local numbness) and inserting a needle into your lump and draining out the fluid. If the fluid does not contain any blood and the lump disappears, then no further tests are necessary. If there is blood in the fluid and if the lump continues, then your doctor may recommend you to a Breast surgeon for further tests. If there is no fluid drawn during aspiration, then your doctor may recommend you undergo further tests to evaluate your lump.

Benefits

The doctor can diagnose the lump in your Breast immediately on the same day after the Cyst aspiration. If the lump you have is a Cyst, you can know right away and no further tests are required.

Risks

Before you undergo Breast Cyst Aspiration, your doctor informs you of the procedure and keeps you informed about the possible problems. You may feel slight pain when the needle goes inside your Cyst and there can be a small bruise on the Breast. At times the place where the needle is inserted may become infected.

Need to see the doctor after Breast Cyst Aspiration

After Breast Cyst Aspiration, you need to see your doctor again after a period of 4 to 6 weeks. The doctor examines whether the Cyst which was drained has developed into a lump again. A recurring Cyst is a problem. If you feel that the Cyst that was aspirated has filled up again with fluid, call your doctor.

Causes of Breast Pain

There are many possible causes of Mastalgia. It may be related to many factors such as

• Pregnancy and menstruation
• Hormonal changes during menstruation
• Menopause
• Pregnancy may cause Breast tenderness to some extent
• Breast pain may occur in teenagers undergoing puberty
• Breastfeeding may also cause pain in the Breast

Pain, swelling and tenderness a few days before periods are usually normal but abnormal pain for no reason that persists for many weeks or months is for sure a reason to worry.

Other causes of Breast pain are:

• Infection or injury to Breast tissues
• Fibrocystic Breast changes (painful and lumpy Breast just before your period)
• Shingles caused by Chickenpox virus (painful, blistering skin rashes on one of your Breast, months or years after you were affected with Chickenpox)
• Breast Cancer can also cause Breast pain (in rare cases)

Types of Breast Pain

There are two types of Breast pain in women-cyclic and non-cyclic.

Cyclic Mastalgia: About 40% of women experience cyclic Mastalgia a week or a few days before having periods. It is related to the menstrual cycle. During a cyclic Mastalgia, you may experience a burning, stabbing, pricking pain in one or both the Breasts. This may also cause pain in the armpits, arms, and shoulders. During the menstrual cycle change in the hormone level increases the sensitivity of Breast tissues. There is fluid retention in the Breast before your periods, as the Breasts are prepared for changes during pregnancy. This fluid retention results in swollen, enlarged, and painful Breasts that resolve during menstruation. Still, no particular hormone has been identified as a contributor to cyclic Mastalgia.

Non-cyclic Breast pain is common in older women. Non-cyclic Breast pain may be in turn divided into two types. First, the pain that originates in the Breast but is completely not related to the menstrual cycle. This is common in older women before and after menopause. The sharp and stabbing pain is confined to a single spot. If you experience sudden, continuous pain it is better to consult your doctor. The second type of non-cyclic Mastalgia originates elsewhere but the pain is felt in the Breast. The pain usually originates in the bones, joints, and muscles called Musculoskeletal Pain. Pain in the chest wall and spine may also result in non-cyclic Mastalgia

Diagnosis

During your visit to the doctor, he may ask about your previous medical history and family history. The doctor will tell you to describe your pain and the area where you exactly feel it.

Visual and manual examination of your Breast will be done to check for any lumps, skin rashes or any other abnormality. Lymph nodes located in your underarms and lower neck will also be examined. Your doctor will listen to your Heart and Lungs; and check your chest wall and abdomen to be sure that the pain originated from your Breast and not from any other source.

If you are less than 35 years of age and your physical examination and medical history don’t show any abnormal results then no additional tests are needed. But if you are above 35 years old, and your physical examination is normal, your doctor may still want you to get a Mammogram done.

If any lump or unusual thickening of the Breast tissue is detected your doctor may ask you to do a Mammogram. This is an X-ray examination of your Breast tissue. An ultrasound may be needed. If lumps are detected on your Breast, then your doctor might suggest a Breast Biopsy, where a small piece of your Breast tissue will be taken and examined under the microscope.

Treatment

There are many treatment options for reducing Breast pain. Depending on what exactly is causing the pain your doctor may decide on one of the treatment options.

• Wearing comfortable underwear and clothing that fits you properly may reduce pain in some women
• A non-steroid anti-inflammatory medicine for non-cyclic Breast pain
• An oral contraceptive can help, if you are already taking contraceptives then your doctor may change the dose accordingly
• Adjust the dosage of your hormone replacement therapy, either by reducing it or by completely stopping it, which your doctor will decide
• The only approved medicine for treating Breast pain and Breast tenderness is Danazol, but it has many androgenic (male characteristic) side-effects like acne, weight gain, and change in voice, thereby limiting its use. Another drug Tamoxifen used for treating Breast Cancer is prescribed for some women but it also has many potential side effects that are even more troublesome than Breast pain
• Change your diet as being over-weight produces an excess amount of estrogen hormone causing Breast pain
• Cyclic Mastalgia: Some say reducing salt consumption may help, but many times this doesn’t help as cyclic Mastalgia is associated with hormonal change and not fluid retention.
• Exercise regularly as physical activity produces endorphin, a natural pain-killer produced in our body

Home remedies

Though there is minimal research supporting these home remedies, they may help a few women to manage their Breast pain. Some tips are worth trying

• Try hot and cold compresses on your Breast
• Wear proper fitting clothing and inner-wear
• If anxiety is the cause of pain try some relaxation therapy at home
• Make changes in your diet and try to shed a few kilos
• Try a pain reliever
• Limit consumption of caffeine

Conclusion

Mastalgia is caused by various factors; it can be Cyclic or Non-cyclic. Generally, Cyclic Mastalgia is more effectively treated than Non-cyclic Mastalgia. Many patients worry more about Breast Cancer than the actual pain caused by Mastalgia. Remember that Breast Cancer is very rarely related to Breast pain. However, it is very important that Breast pain needs to be checked to make sure and rule out the presence of Cancer. Any pain that lasts longer is difficult to deal with therefore consult your doctor and learn ways to manage your pain in addition to the doctor’s plan.

Causes

The causes of Buerger's Disease are not precisely known. The swelling and inflammation are believed to be caused by vasculitis, where the defence system of the body, called the Immune System, triggers the inflammation by default. There is also believed to be a genetic predisposition to this condition.

Cigarette smoking or the use of tobacco products in any form precipitates inflammation, swelling, and blockage.

The toxins in tobacco products are said to cause spam and narrowing of the blood vessels, hence causing the symptoms of Buerger's Disease.

Symptoms

• The commonest initial symptom is pain. The pain aggravates using hands and feet and seems to settle with rest. This phenomenon is called claudication.
• The superficial blue blood vessels that carry blood from extremities to the Heart may be inflamed, and hence appear prominent and painful to touch.
• The fingers and toes may turn pale especially when exposed to cold. This is called the Raynaud’s phenomenon.
• There may also be a tingling sensation. This happens because cold causes spasms of the blood vessels supplying blood to the extremities.
• Painful sores and ulcers may appear on the skin as the skin tissues are deprived of blood.
• Persistent paucity of blood supply to the skin causes decay, called Gangrene. The tips of the fingers and toes may become black and the damage is irreversible.

Complications

The most feared complication of Buerger's Disease is Gangrene. The skin overlying the affected part becomes blue or black, loses sensation, and may smell foul. Since this is permanent death of skin tissues, it can necessitate permanent surgical removal of the affected part, called amputation.

Ulcers that develop on the legs and arms may become infected. Muscles in nearby regions go weak and may waste away over time.

Diagnosis

Buerger's Disease is a high possibility in a smoker who complains of intermittent pain that comes with activity and settles with rest.

The doctor may feel the pulses in regions just above the affected parts. Pulse in the extremities may feel weak.

The doctor may then conduct Allen’s test to check the speed of blood flow in the arms. The patient is required to make a fist and the doctor presses upon the blood vessel of the hand until the hand turns pale. This pressure is then slowly released to allow the blood to flow into the hand. How fast the blood flows and changes colour is then noted.

Another test that may be done is an Arteriogram or angiogram. In this, a dye is injected into the body such that it flows down to the blocked vessels. X-ray images are then taken to study the flow through the vessels. This is a reliable test that helps to detect even the early signs of disease. The blood flow characteristics can be studied by doing an ultrasound.

Blood tests may be done to rule out other conditions like clotting disorders, or Diabetes, and to study the activity of the Immune System.

Treatment

• Giving up smoking and other tobacco products can halt the disease.
• Medicines may be prescribed to dilate the blood vessels or dissolve the clots.
• Some medicines may stimulate the growth of new blood vessels (therapeutic angiogenesis).
• Surgery may be done to cut the nerves of the affected area to control pain and increase blood flow.
• The role of medicines and surgery though is not very well defined.
• If there is a persistent ulcer or Gangrene, amputation may be necessary.

Prevention

• The best prevention is to quit tobacco in any form.
• Medical help and community and family support should be sought to quit smoking.
• Complications can be prevented by exercising precautions.
• Extremes of cold should be avoided.
• Footwear and gloves may provide warmth.
• Shoes should be comfortable and well-fitting.
• Cotton socks should be preferred to those made of synthetic material.
• Soft padding may be placed inside the shoes for protection.
• Walking with bare feet should be avoided.
• The extremities should be regularly inspected for any ulcers and sensation should be checked constantly.
• If any ulcer or diminished sensations appear, medical help should be sought.
• Moderate physical activity can be done after seeking medical advice.
• A good nutritious diet should be taken.
• Smoking is deleterious for your limbs. Quit now.

Signs and symptoms

In most cases, Carpal Tunnel symptoms develop gradually without any specific reason. Usually, the symptoms come and go but, if the condition gets severe, the symptoms may occur more frequently and persist for a longer duration.

The first symptom is numbness or tingling in your thumb, index and middle fingers that awakens you at night. You may also feel discomfort in the wrist and hand.

• Pinching and needle-like sensation or pain in the hand
• Your fingers may feel stiff when you wake up
• You may also experience weakness in your hand and tend to drop objects very often. This is due to the numbness in your hand or weakness of the thumb’s pinching muscles that are controlled by the median nerve.
• With moderate pain, you may not be able to brush your hair or hold a fork, pinch an object and open a jar using a screwdriver.

Not all pain in the hands is caused by Carpal Tunnel Syndrome. It may also be due to an injury to the muscles, ligaments and tendons, or nerve problems and inflammation in the thumb joint or wrist.

When to seek medical advice?

Consult the doctor immediately when you have the symptoms mentioned above and if the symptoms interfere with normal activities. Remember!! If you ignore the condition, you may end up with permanent nerve damage.

Causes

This condition is caused by the compression of the median nerve that runs from your forearm in your wrist (Carpal Tunnel) to your hand. Other carpel tunnel syndrome causes include:

• Reduced blood flow to the hands
• Obesity
• Conditions such as Rheumatoid Arthritis, Gout, Diabetes, and Hypothyroidism
• Repeated hand movements
• Bone spurs; take up space in the Carpal Tunnel and put more pressure on the median nerve

Carpal Tunnel Syndrome is a work-related condition caused by:

• Forceful hand movements
• Hand-arm vibration
• Working for long hours in the same position (on hand)

Risk factors

Risk factors include:

• Gender - Women and older people are more likely to develop the condition.
• Heredity
• Repetitive hand use
• Pregnancy
• Health conditions; such as menopause, Obesity, and Thyroid gland imbalance
• Alterations in the balance of body fluids
• Inflammatory conditions such as Rheumatoid Arthritis

Diagnosis

Your doctor will talk to you about general health, and ask about the symptoms and medical history. Then he or she would perform a physical examination to test the feeling of the fingers and muscle strength in your hand.

The doctor would bend the wrist, and tap or press on the nerve to put pressure on the median nerve.

Other tests are also recommended such as:

• Electromyogram - to determine if muscle damage has occurred
• Nerve conduction study - to diagnose the condition and to determine other conditions
• MRI Scans, X-rays, and CT Scan tests are also performed to determine if there are problems with the nerve itself and to determine the causes of your symptoms

Treatment

As mentioned above, the condition should be treated as early as possible once you start experiencing the symptoms to prevent complications. The Carpal Tunnel Syndrome treatment depends on how severe your pain and symptoms are, and if there is a weakness.

Non-surgical treatment

If you get diagnosed with the condition in the early stages, the symptoms can be relieved without surgery. These treatment options include:

Surgery

If the non-surgical options do not manage the symptoms, the doctors would suggest you go for the Carpal Tunnel surgery. Before that, discuss with your doctor regarding the risks and complications associated with the surgery. There are two different surgical techniques, but the goal is common; to manage the symptoms.

Open Carpal Tunnel Release – A large incision is made on the palm over the Carpal Tunnel and cuts the ligament to free the nerve.

Endoscopic Carpal Tunnel Release – The ligament is cut through one or small incisions in your hand. This technique results in less pain compared to the open technique.

It may take a few weeks to resolve the condition.

Self-management

Follow these tips to get temporary relief from the symptoms:

• Take regular breaks from repetitive activities that involve hand usage.
• Rotate your wrists and stretch your palms and fingers.
• Take OTC drugs such as aspirin and ibuprofen if the pain is severe.
• Avoid sleeping on your hands.

Symptoms

The classic symptom of Chickenpox is an itchy rash. Other Chickenpox symptoms include:

• Fever
• Headache
• Loss of appetite
• Fatigue

The rash goes through three phases, raised bump, fluid-filled blister, and crusts or scabs. The rashes can appear anywhere on the body.

The symptoms appear after 10 to 21 days of exposure to the virus, and these symptoms are seen up to five to ten days.

Causes

There are different causes of Chickenpox; it is mainly caused by the varicella-zoster virus. The infection occurs through airborne transmission and when coming in contact with the infected person. It can spread through saliva (by coughing or sneezing) and contact with blisters.

Risk factors

The risk of Chickenpox infection increases if you haven’t had Chickenpox infection before. The risk also increases if you are not vaccinated. In rare cases, few people can get this infection more than once.

Complications

Often, Chickenpox is a mild disease. However, in a few cases, it can be severe and may lead to death. The complications that can be seen are Dehydration, Pneumonia, bacterial infections of the skin, bones, or bloodstream, Toxic Shock Syndrome, and Reye’s Syndrome. Reye’s Syndrome can occur if you take aspirin during Chickenpox.

If pregnant women get Chickenpox, birth defects may occur such as growth impairment, vision problems, and intellectual disabilities.

The infection may recur in some cases such as Shingles.

Diagnosis

Your doctor diagnoses Chickenpox by physical examination of the blisters. Blood tests or a culture of lesion samples are also performed to confirm the diagnosis.

Treatment

Mostly, your doctor may advise you to manage the symptoms in healthy children. Your doctor may prescribe an antihistamine to treat itching.

The doctor may give appropriate treatment to reduce the risk of complications. Chickenpox treatment for kids includes an anti-viral drug or immune globulin. These medications shorten the duration of infection and reduce the severity.

Self-management

Taking lukewarm baths and wearing protective, lightweight, and cotton clothing can soothe the symptoms. Instruct your child not to scratch, as infection gets into the skin. Keep your children out of school and daycare to prevent the spread of the infection.

Prevention

Vaccination is the best and safest way for Chickenpox prevention. In most cases, the infection is mild. However, it is better to get vaccinated to prevent the infection. The first shot of the Chickenpox vaccine is given at 12 and 15 months of age, and a booster dose is given between 4 and 6 years of age.

Avoiding contact with infected people can also prevent infection.

Signs and symptoms

The symptoms of Chikungunya show up between 3-10 days after being bitten by the infected mosquito. They are as follows:

• Sudden high fever without any prior underlying infection and can go as high as 103-104.
• The rash can appear within 48 hours mainly on the face and limbs.
• Severe headache
• Pain behind the eye increases with eye movement
• Nausea
• Vomiting
• Low Blood Pressure
• Difficulty in breathing

Causes

The female Aedes mosquito is responsible for causing Chikungunya.

Diagnosis

Only a blood test can definitively diagnose Chikungunya as symptoms are not always easy to tell apart from other conditions.

Treatment

• Rest in the acute stage of the disease. The patients are prone to Dehydration and therefore, are advised to increase their fluid intake
• Relief of pain and fever by acetaminophen (paracetamol) or ibuprofen, but not in the first three days
• Home remedies that can be tried for treating Chikungunya
• Consuming ginger tea and green tea can help relieve inflammation.
• Applying an ice pack on the joint for a while will help reduce inflammation and pain.

Self-Management/Prevention

• If you already have Chikungunya, avoiding getting bitten is still important because the mosquito will transmit the disease from you (infected person) to another non-infected person.
• Use insect repellents with any of the following ingredients: Picaridin, DEET or oil of lemon eucalyptus, to avoid mosquito bites.
• For example: Odomos, a popularly available mosquito repellent cream.
• Don’t leave open water spaces in and around your house since the Aedes mosquito often breeds in dark, enclosed spaces. Within your personal space, consider covering overhead tanks or even bathtubs and flower pots where water may stagnate.

Symptoms of Chlamydia

Chlamydia is called a “silent disease” as it usually doesn’t show any signs and symptoms. If at all symptoms are seen then it appears within 1-3 weeks of exposure.

A few Chlamydia symptoms that show up in women are:

• Infection in the cervix and urethra
• Abnormal vaginal discharge
• Burning sensation while urinating

If untreated, the infection spreads up affecting the vagina, cervix, uterus, fallopian tube and ovaries resulting in Pelvic Inflammatory Disease (PID).

Few with PID show symptoms like:

• Lower abdominal pain
• Pain in lower back
• Fever
• Nausea
• Pain during intercourse
• Bleeding between menstrual cycles

Many do not show any signs and symptoms of Chlamydia making it difficult to diagnose at the early stage.

The symptoms of Chlamydia in men are:

• Abnormal penile discharge
• Burning sensation during urinating
• Itching
• Burning around the penis opening

Partners who have receptive anal intercourse may acquire an infection in the rectum resulting in pain, discharge and bleeding in the rectum.

The bacteria Chlamydia is also found in the throat region of men and women and is transmitted during oral sex with an infected partner.

Most men actually wait to see whether these discomforts go away, and many symptoms disappear too, but you may be still harbouring the infection internally, therefore you must get it tested before serious complications invade. The ultimate result in an untreated individual is infertility.

Transmission of infection

Chlamydia is a sexually contagious disease; any sexually active person can be infected with Chlamydia as it spreads through semen and vaginal secretion. The bacteria causing Chlamydia spreads during vaginal, anal or oral sex. As it has no symptoms the infected person may transmit it to his/her partner unknowingly. The more the number of sex partners the more higher the risk of being infected.

In young women and teenage girls, the cervix is not fully matured, therefore it is more susceptible to infection. Since the bacteria pass through oral and anal sex, it can affect homosexuals also.

Chlamydia can be passed from mother to newborn during vaginal delivery, and cause eye infection and Pneumonia in the newborn. The bacteria do not spread through casual touching or handshakes.

Treating Chlamydia

As Chlamydia doesn’t show any symptoms it is difficult to diagnose it in the early stage. But if you or your physician suspects that you might be infected with Chlamydia, he might perform a few simple tests to confirm whether or not you are affected.

In women, diagnosis can be done using a urine sample or a vaginal swab. Your healthcare provider also looks for symptoms such as cervical discharge. Swabs taken from the cervix, urethra or anus can also be used. In men, a simple urine sample is enough to get reliable results. In very rare cases urethral samples are taken. The results usually come within 7-10 days.

Chlamydia can be treated effectively and cured completely with antibiotics. A single dose of azithromycin or doxycycline twice every day for a week proves effective. Make sure that your sexual partner is also treated for the same and abstain from sex until your physician confirms that you and your partner are cured completely, as the chance of the reappearance of infection is high with an untreated partner.

Multiple infections in women result in serious reproductive complications. To avoid complications and to make sure that the infection has not returned, retest yourself three months after the initial treatment of Chlamydia.

Remember to complete the full course of medicine even if the symptoms disappear, as the infection might be still in your body. Schedule regular follow-up visits to avoid recurrence.

Complications if left untreated

As said, Chlamydia is a silent infection that grows quietly without any signs and symptoms, it becomes difficult to detect it in the earlier stage. If left untreated, it can result in various serious complications.

In women, the infection spreads causing pelvic inflammatory disease (PID). PID and infection in the upper genital tract can silently damage fallopian tubes, the uterus and the surrounding tissues. This damage results in pelvic pain, infertility and ectopic pregnancy (development of the fetus outside the uterus).

It also increases the risk of being affected with HIV, if exposed. In men, complications are very rare. Sometimes the infection might spread to epididymis causing pain, fever and rarely sterility. Very rarely it might infect skin causing skin lesions; inflammation in the eyes and urethra, and Arthritis.

Preventing second infection

One way of preventing the spread of sexually transmitted infections is to abstain from sex till the infection is cured completely. You should maintain a monogamous relationship with an uninfected partner.

During sexual intercourse, using a latex condom reduces the risk of STDs. Women should avoid using douche (rinsing of the vagina) as it reduces the number of good bacteria in the vagina and increases the risk of infection.

Annual screening for STDs is recommended for sexually active persons and women above 25 years and for older women who are at high risk. Consult your health care provider once you notice any symptoms of STD.

Keeping talks open

It is very difficult to talk to anyone about sex-related diseases as is with any other medical issues. But it is very important that you need to be aware of STDs and their complications.

Educate yourself and your partner that STD does not show any symptoms, and therefore, you must follow safe sex.

Do not hesitate to have yourself checked for STDs at least once annually. Talk to your health care specialist if you have or suspect any abnormality.

Always remember “An ounce of prevention is worth a pound of cure”.

Symptoms

The primary chronic fatigue syndrome symptom is severe tiredness which can last for as long as 6 months or even more in some patients. Additionally, you may have at least four of the below symptoms:

• Headache
• Sore throat
• Joint pain (involving many joints)
• Muscle pain
• Sleep disorders
• Feeling uneasy for at least 24 hours after physical activity
• Memory problems
• Tender lymph nodes

Based on the severity of your symptoms, CFS is classified as below:

Mild: You can take care of yourself but may need some rest frequently

Moderate: You will have difficulty in moving and may need an afternoon nap

Severe: You will have difficulty concentrating and a drastic decrease in mobility

Causes

The exact cause of chronic fatigue syndrome is not known. The possible causes could be hypotension (low Blood Pressure), viral or bacterial attacks, weak Immune System, stress, and hormonal imbalances. CFS can also occur in people with genetic predisposure.

Risk factors

Below are the risk factors for chronic fatigue syndrome:

Elderly: CFS can occur in people of any age group. However, it is more common in people aged 40’s and 50’s.

Gender: Women outnumber men by nearly four times in getting CFS as per the statistics provided by the CDC (Center for Disease Control and Prevention).

Other factors include genetic predisposition, stress, allergies and environmental factors.

Complications

Chronic fatigue syndrome if not addressed timely can lead to certain complications such as:

• Depression
• Regular absenteeism at work
• Social withdrawal

Lifestyle restrictions

Diagnosis

As the symptoms of CFS are similar to the other conditions, it is advisable not to self-diagnose but to consult a doctor instead. Even for a physician, it is challenging to diagnose CFS as the symptoms are common with many other medical conditions.

There are no laboratory tests available for diagnosing CFS. If you have at least four of the above symptoms in addition to severe fatigue for more than 6 months, then you might be diagnosed with CFS. Further assessments include:

• Review of medical history including those causing fatigue and other related symptoms
• A thorough physical and mental state examination
• A battery of laboratory tests to rule out other possible conditions for the symptoms

Treatment

A complete cure is not possible but chronic fatigue syndrome treatment involves management of the condition and its symptoms. Your doctor chooses the best treatment plan for you from the main treatments detailed below:

Medications

• Antidepressants are given to cope with your illness. Low doses can also help in improving sleep.
• Sleeping pills may be recommended when other home remedies are not effective.

Exercise

• A structured exercise program called graded exercise therapy is suggested by your physiotherapist. It begins with stretches and range-of-motion exercises for a few days. Follow these specific exercises without fail.

Psychological counselling

• A psychological counsellor can help you find ways to overcome the limitations of CFS.

Self-management

By taking certain steps, you can overcome the trouble with the symptoms of chronic fatigue syndrome:

Make the best during your peak energy hours: Do your routines when your energy levels are high. If possible maintain a diary and note down the timings of your high energy. If you notice a pattern in this, plan your work accordingly.

Do not overdo: Take charge as per your energy levels. However, do not work too hard as you may become overtired and it may become difficult for you to recover.

Improve your sleep: Follow a regular schedule of going to bed and getting up in the morning. This helps you to have a better sleep. It is advisable to avoid caffeine, alcohol, nicotine, etc. which can affect your night’s sleep.

Stretch every day: Regular gentle exercise is quite helpful. You may perform stretches instead of vigorous exercises.

Take care with medications: If you have joint or muscle pain, you may take non-prescription medicines such as acetaminophen, naproxen or ibuprofen.

Eat a balanced diet: Eat fruits, vegetables, cereals, legumes, grains, fish, low-fat dairy and lean meat such as skinless chicken, red meat, etc. regularly.

Reduce stress: Adopt the best techniques which are more suitable for you to overcome stress. Follow relaxation techniques such as breathing, listening to music, dancing, playing your favourite simple games, etc.

Symptoms

Early Dehydration symptoms include:

• Excess thirst and dry mouth
• Dizziness and lightheadedness
• Tiredness
• Amber-coloured urine with a strong smell
• Reduced tears while crying
• Feeling drowsy or sleepy

As the severity of Dehydration increases, the following symptoms of Dehydration will appear:

• Sunken soft spot on the head and sunken eyes
• Low Blood Pressure and increased Heart rate
• Rapid breathing
• Decreased urine output
• Withering of skin

If you have severe symptoms, you need immediate medical help as it can lead to shock.

Causes

The main cause of Dehydration is not taking adequate amounts of water to replace the lost fluids. The other causes include:

Excessive sweating: If you sweat excessively, you can get dehydrated as you lose more amount of fluids. This is more common during hot climatic conditions such as extreme summers.

Illnesses: Certain illnesses also can cause Dehydration due to continuous vomiting and Diarrhoea.

Fever: In an attempt to reduce your body temperature which is high during fever, excess fluids are lost. If the fluids lost are not replenished with adequate fluid intake, it can lead to Dehydration.

Excessive urination: Certain medical conditions cause chemical imbalances which increase urine output leading to Dehydration.

Risk factors

The risk of Dehydration is high in certain populations including:

• Athletes, especially bodybuilders and swimmers who are regularly exposed to direct sun
• Seniors, infants, and young children
• People with chronic illnesses
• People who stay at high altitudes
• Workers exposed to extreme sun rays (e.g. welders, construction workers, landscapers, etc.)

Diagnosis

When you report the symptoms of Dehydration, your doctor checks the vital signs and if there is a low Blood Pressure, increased Heart rate, fever and fast breathing, an initial clue of Dehydration is obtained. Further to determine the underlying cause of Dehydration, blood and urine tests are performed.

Urine analysis shows high specific gravity and ketone bodies, the degree of which indicates the severity of Dehydration.

The amount of sodium and potassium in the blood and the indicators of Kidney function such as BUN and creatinine also indicate the degree of Dehydration.

Complications

If Dehydration is not treated, it can lead to life-threatening complications such as:

• HeatStroke
• Seizures (due to excess electrolyte loss)
• Heat cramps
• Heat exhaustion
• Kidney Failure
• Low blood volume
• Coma

Treatment

The strategies for treating Dehydration are given below:

Rehydration: The first focus of Dehydration treatment is fluid replacement. In this method, fluids are replaced either through drinking (mild cases) or through IV injections (severe cases). The solutions are often a mix of water and electrolytes.

Medications: Based on the cause of Dehydration, you may be given medicines such as acetaminophen (to treat fever). It is advisable to avoid salt medications as they can lead to serious complications.

Self-management

Follow these steps to reduce the severity of Dehydration:

• Keep sipping small amounts of water regularly. Do not drink soda, coffee or sweet drinks.
• Take drinks containing carbohydrates and electrolytes. You may prepare rehydration fluids by adding half a teaspoon of salt, and six spoons of sugar to one-litre water.
• If heat exposure is the reason, the person should be cooled down by removing excess clothing and providing air conditioning. However, exposure to excess colds such as ice packs should be avoided.

Types of Dengue

Dengue fever can be classified into different severities such as:

Mild Dengue Fever: This stage hardly leads to fatal complications. At this stage, the symptoms will disappear after seven days. The symptoms of mild Dengue fever include high fever, body rashes, muscle and joint aches, intense headache, nausea, and vomiting.

Dengue Hemorrhagic Fever (DHF): The symptoms of DHF may be mild on the onset but worsen gradually. Mild Dengue symptoms along with some severe symptoms such as a bleeding nose, bleeding gums, blood spots under the skin, clammy skin, and sensitive skin are observed. DHF can result in damaged lymph and blood vessels, decreased platelet count, internal bleeding, and weak pulse rate. DHF can result in death if untreated.

Dengue Shock Syndrome: The progression of DHF symptoms can lead to massive bleeding, shock, and death which is referred to as Dengue sock syndrome. The symptoms include mild Dengue fever, DHF, and additionally sudden Hypotension, heavy bleeding, regular vomiting, intense Stomach pain, and disorientation.

Symptoms of Dengue fever

Febrile Phase

• Sudden onset of fever
• Rashes
• Headache
• Bleeding nose and mouth
• Vomiting
• Diarrhoea
• Joint and muscle pains

Critical Phase

• Hypotension
• Pleural effusion
• Ascites
• Gastrointestinal bleeding

Recovery Phase

• Itching
• Seizures
• Slow Heart rate

Diagnosis

Accurate diagnosis is essential to diagnose Dengue fever as most of the symptoms are similar to Malaria and typhoid. The laboratory tests that are performed for the diagnosis of Dengue fever include:

Complete Blood Count test (CBC): It is performed to measure the concentration of white blood cell count, red blood cell count and platelets in the body.

Reverse Transcriptase-polymerase Chain Reaction (RT-PCR) Test: It is performed to identify the Dengue virus.

Enzyme-linked Immunosorbent Assay (ELISA) Test: It is performed to identify the count of antibodies that are present in the blood.

Hemagglutination Inhibition Assay (HI Assay): It is performed to identify the serum antibodies.

Liver Function Tests: These are carried out to determine the elevations in serum albumin and transaminases.

Dengue Fever Treatment

There is no specific Dengue fever treatment. Depending on the severity of the condition, rehydrating fluids and salts are given to the patients. Tylenol (Paracetamol) can be used to treat pains and high fever. Non-steroidal Anti-inflammatory Agents such as aspirin and ibuprofen can cause severe internal bleeding if used in the treatment of Dengue. So, medicine for Dengue should be given only under the supervision of a doctor.

In case of severe Dengue forms, intravenous fluid supplementation, and blood transfusions are given.

Immunization

In early 2016, the first Dengue vaccine (Dengvaxia) by Sanofi Pasteur was registered.

Dengue Prevention

Protecting from mosquito bites can help in preventing Dengue fever. The best prevention methods include:

• Preventing the multiplication of mosquitoes by removing stagnant waters
• Proper disposal of solid wastes
• Cleaning and emptying of domestic water storage every week
• Usage of appropriate insecticides in water storage containers
• Using window screens for household protection
• Wearing long-sleeved clothes
• Use of mosquito traps, insecticide-treated materials, coils and vaporizer
• Applying insecticides as sprays during outbreaks to control vectors
• Monitoring and surveillance of vectors to determine the effectiveness of control interventions

Causes

Diarrhoea is called Stomach flu or Intestinal Flu. It is a viral infection that infects your gut. It also occurs if you:

• Take laxatives regularly (laxative abuse)
• Consume more amounts of alcohol (alcohol abuse)
• Drink contaminated water or eat contaminated food
• Get infected by certain viruses (rotavirus, norovirus, and flu)
• Have diseases that affect the small intestine, or colon, such as Crohn’s disease, irritable Bowel syndrome

Some people also get Diarrhoea post-stomach surgery. After the surgery, there are chances that the food moves through the digestive tract more quickly than normal.

Symptoms of Diarrhoea

You may have symptoms such as:

• Fever
• Loose stools
• Watery stools
• Abdominal cramps
• Nausea and vomiting
• Bloating in the Stomach
• The feeling of urge to defecate

More serious Diarrhoea symptoms include:

• Bloody stools
• Mucus in stools
• Unusual weight loss

Continuous watery stools that occur more than thrice a day are dangerous and you may get dehydrated. To avoid this, you must drink enough fluids.

When should I call a doctor?

You must call your doctor immediately if you have:

• Dry and scaly skin
• Dark-coloured urine
• Dark blackish stools
• Fever that is 101˚F or above
• Noticed blood in your stools
• Severe pain in the abdomen
• Severe nausea and vomiting
• Fast Heart rate (tachycardia)
• Diarrhoea lasting for more than two days

Diagnosis

To find out the underlying cause of Diarrhoea your doctor may take a medication history, and perform a thorough physical examination. Stool or blood may be tested to know about the type of bacteria, parasites or viruses. If you have Chronic Diarrhoea, your doctor would ask you to go for other tests to look for the signs of the disease. You should avoid certain foods that may trigger your Diarrhoea.

Treatment of Diarrhoea

In Diarrhoea, you will feel exhausted due to the loss of body fluids. So, to rehydrate, your doctor would replace the lost fluids and electrolytes to prevent Dehydration. Your doctor would choose an appropriate treatment option based on the underlying cause.

If you are suffering from Diarrhoea, then you must drink plenty of water, and fruit juices and eat a soft and bland diet. You must avoid taking foods that contain caffeine and salty broths. In the case of Diarrhoea in children, you must give oral rehydration solutions to replace the lost fluids and electrolytes.

Prevention

Yes, prevention is always better than cure. Only two types of Diarrhoea can be prevented - rotavirus Diarrhoea and traveler’s Diarrhoea. There are immunization schedules for rotavirus Diarrhoea; these vaccines are given in two to three doses for infants.

When travelling to developing countries, you can prevent the risk of a Traveler’s Diarrhoea by:

• You must drink only boiled or purified water
• You must make sure that the food is cooked properly
• You must avoid eating unwashed or unpeeled raw fruits and vegetables

Dizziness has no particular medical meaning. Four different conditions are referred to as the types of dizziness:

• Vertigo: you may feel that you are in motion when there is no motion. It would be like the environment around you is spinning round and round.
• Lightheadedness: this is also called Syncope. If you feel like fainting, then it is said to be lightheadedness. This happens when you stand up quickly or when you take deep breaths.
• Disequilibrium: you may feel unsteady on your feet while walking and you may also feel like falling if you have disequilibrium.
• Anxiety: some people may use the word “dizzy” if they are panicky, depressed, or anxious.

Causes

Many causes make you feel dizzy, which include:

• Infection: In case you have any infections such as ear infections, or common cold or Diarrhoea. These conditions can cause temporary Vertigo.
• Meniere’s Disease: this is characterized by episodes of long-lasting severe Vertigo. Other symptoms of this condition may include ringing in the ears (Tinnitus), hearing loss, or fullness in the ears.
• Dandy’s Syndrome: in this condition, you may feel that everything is jumping up and down. This happens when you take any antibiotic that is toxic to your ear. However, it may get set over time.
• Tumours or Stroke: these conditions can also trigger the state of dizziness, but rarely.
• Parkinson’s Disease: this disorder can also make you stoop forward due to dizziness.
• Low blood sugar levels: if you are diabetic, you may feel dizzy due to the low sugar levels in the blood.
• Dehydration: you may feel dizzy if you have heat exhaustion due to fever, Diarrhoea, etc.,
• Migraine: you may feel dizzy before and after you have an episode of a headache.

Symptoms of Vertigo

Often dizziness symptoms are accompanied by:

• Headache
• Confusion
• Disorientation
• Feeling off balance
• Chest tightness
• Nausea or vomiting
• Weakness or tiredness

Diagnosis

Your doctor would evaluate and treat the underlying serious cause of dizziness. Your doctor may ask you about the history of dizziness and the type of dizziness that you are experiencing. Depending on your health history, your doctor would order some diagnostic tests.

The tests may include:

• CT Scan
• Blood tests
• Eye examination
• Dox-Hallpike Test
• Cardiac Stress Test
• Electrocardiogram (ECG)
• Bleeding and clotting time

Treatment

The medical treatment for dizziness is purely based on the underlying cause or disease.

Dizziness may be a symptom of something dangerous and must always be discussed with the doctor. It can also be drug-induced, so if you discuss it with your doctor, he or she may change the medication that you are using for any other underlying condition.

Here are some of the home remedies that work well for you if you are dizzy:

• Avoid stress and anxiety; this can help you keep dizziness at its Bay
• You must take plenty of fluids and food and an ample amount of rest.
• You must not stand up suddenly, and must not change the positions suddenly.
• You must make sure that there are no rugs or carpeting that may make you fall if you are dizzy

Medical treatment

Treatment varies depending on the cause. Some of the common treatments for conditions that cause dizziness include:

• If a Heart Attack or Stroke is the cause of your dizziness, then an emergency blood transfusion or surgery would be beneficial
• If Dehydration is the cause of your dizziness, then intravenous fluid administration can be useful.
• If the underlying cause for dizziness is shortness of breath, then the oxygen supply would correct the dizziness.

Medications such as benzodiazepines are used to control fainting or spinning around feelings.

About Ebola Virus transmission

Ebola Disease is not a contagious disease. It spreads to people by skin contact or by bodily fluids of infected animals such as the monkey or a chimpanzee. Then it travels from person to person.

Causes

Ebola Viruses which belong to a family of viruses, ‘Filoviridae’ are the causes of Ebola. These viruses cause Ebola Hemorrhagic Fever (bleeding fever) inside and outside the body. The Ebola Virus is found in chimps, African monkeys, and other nonhuman primates.

Symptoms

The symptoms of Ebola are presented within 8 to 10 days after the exposure or may take three weeks to appear.

The foremost prominent symptom would be extreme fatigue; other Ebola Virus symptoms would include:

• Fever
• Chills
• Diarrhoea
• Weakness
• Chest pain
• Stomach pain
• Rashes on skin
• Internal bleeding
• Unusual weight loss

Risk factors

The risk of getting Ebola increases if you are:

• Traveling to Africa where there is an increased risk of contracting the disease due to Ebola Virus outbreaks
• Conducting animal research may keep it at a higher risk of acquiring Ebola Virus, especially when conducting trials on monkeys
• Providing personal care to the Ebola-infected persons
• Preparing burials for the people who died due to Ebola, preparing these bodies for burial would increase your risk of developing the disease

Complications

The fatal complications of Ebola Virus Disease are:

• Coma
• Shock
• Seizures
• Jaundice
• Delirium
• Multiple Organ failures

Diagnosis

Early symptoms of Ebola would be similar to those of common diseases such as flu, Malaria, and typhoid fever.

Your doctor would order blood tests that would reveal the antibodies of the Ebola Virus. At the same time, these tests would reveal the white blood cell counts, platelet count, the status of the Liver enzymes, and abnormal coagulation factor levels.

Treatment

The Ebola Virus does not have a complete cure or any preventive vaccines. The Ebola treatment is purely based on comforting the patients and management of the Ebola Disease symptoms.

The supportive care measures may include:

• Supply of extra oxygen if needed
• Treatment for co-existing infections
• Administration of blood products if required
• Management of fluid balance by electrolytes
• Prevention of other infections from occurring
• Administration of medications to maintain stable Blood Pressure

Prevention

It is not enough if you understand the Ebola Virus symptoms and treatment to be safe. You can be more proactive and protect yourself from the effects of the Ebola Virus, by following the below steps:

• Avoid handling the belongings of the Ebola-infected person
• Avoid any skin contact with the blood or bodily fluids of an infected person
• Practice good hand hygiene, and wash hands with an alcohol-based sanitiser
• Wear protective clothing when around animals such as chimps and monkeys.
• Refrain from engaging in burial rituals that involve handling the body of a person who died of the Ebola Virus

Types of Edema

There are many types of Edema, but the common ones are:

Peripheral Edema: occurs in hands, legs, arms, and ankles

Cerebral Edema: occurs in and around the Brain

Eye Edema: occurs in and around the eyes. Examples include Macular Edema, Corneal Edema, and puffiness around the eyes is also a type of Edema called Periorbital Edema.

Pulmonary Edema: occurs due to retention of fluid in the Lungs

Signs and symptoms

The Edema symptoms develop gradually over time and depend on the underlying cause.

• Swelling or puffiness under the injured skin is the most common symptom of Edema
• Stretched skin
• Swelling of the abdomen
• When pressure is applied for a few seconds with a finger, the skin retains a dimple, a condition called pitting Edema

Call your doctor immediately when you experience the symptoms mentioned above and when you have chest pain and difficulty breathing.

Causes

Edema occurs when the blood vessels leak fluid into the surrounding tissues. Mild cases of Edema occur if you sit or stay in one position for too long (one of the important causes of pedal Edema) or if you eat too much salty food. Pregnancy and premenstrual signs also cause Edema.

The other causes of Edema are:

Medications: Certain medications such as High Blood Pressure medications, nonsteroidal anti-inflammatory drugs, steroidal drugs, estrogens and Diabetes drugs can cause Edema.

Health conditions: Edema can be a sign of underlying health conditions such as Congestive Heart Failure, Liver Damage, Kidney Damage, weakness or damage to veins in your legs and damage to the Lymphatic System. Diabetes and Arthritis also cause Edema in your hands and legs.

Risk factors

If you are pregnant, your body stores more sodium and water than usual, increasing the risk of Edema disease. Certain medications like steroids and estrogens also increase the risk of Edema. Sometimes, a lymph node gets obstructed after the surgery, leading to Edema of an arm or leg on one side.

Complications

If you do not treat Edema on time, then you may develop complications like difficulty walking, stiffness of the arms and legs, decreased blood circulation, elasticity of arteries, veins, joints, and muscles and increased risk of Skin Ulcers.

Diagnosis

Your doctor will perform the physical test and ask about your medical history. If there are any indications of an underlying medical condition causing Edema, your doctor will recommend tests such as X-rays, ultrasound exams, blood tests and urine tests.

Treatment

Mild Edema usually goes away on its own when you raise your affected limb higher than your Heart. This is the best approach to mild leg swelling treatment.

More severe Edema treatment involves the use of medications such as diuretics that expel excess fluid from the body in the form of urine. This approach is followed as a part of pulmonary Edema treatment.

Treatment for Edema caused by blood clots requires the use of blood thinners that break the clot. Chemotherapy or Radiation is also recommended if the Tumour blocks blood or lymph resulting in Edema.

Home remedies

Following certain tips can help you manage Edema at home.

• Perform exercises to move the body parts that are affected by Edema.
• Elevate the swollen body part above your Heart; do this many times a day
• Massage the affected area towards your Heart by applying firm pressure. This helps to move the excess fluid out of that area
• Use compression stockings, sleeves or gloves as they put pressure on the affected limbs as a part of swollen legs treatment etc.
• Last but not least, reduce salt intake as salt increases fluid retention and worsens Edema.

Causes

The exact cause of (ET) and (MPNs) is unknown. These conditions are not genetically inherited ones. However, there is a chance of familial predisposition to the disease in a few patients.

It is believed that mutation in the genes modifies the activity of the proteins that control the pathways in patients with ET because signalling pathways play a vital role in cell regulation, growth, and development.

Risk factors

The most common risk factors associated with ET are:

The foremost prominent symptom would be extreme fatigue; other Ebola Virus symptoms would include:

• Gender
• Women are at a higher risk for developing ET
• JAK2 mutation
• Mutation to these genes makes the body produce an abnormal or increased number of cells
• Age
• If you are older than 50 years, then the risk of developing ET is high, but there is still evidence that people below 40 years have also suffered from the condition.

Symptoms

In the early stages, ET is asymptomatic. If the symptoms are present they may commonly include the symptoms related to small vessel damage such as:

• Headache
• Blurred vision
• Bluish colouration of fingers and toes
• Burning sensation, and pain in the hands and feet
• Nosebleed or heavy menstruation
• Gastrointestinal bleeding
• Blood in urine

Complications

There may be chances of thrombotic complications that result in Stroke, Transient Ischemia Attack, Heart Attack, Deep Vein Thrombosis (DVT), and blood clotting in the abdominal veins.

Diagnosis

Your doctor might order the following tests to detect ET in you:

Blood test: A routine blood test may show a high count of platelets. This is also performed to exclude other causes such as Iron Deficiency Anaemia and inflammation in the body.

Bone Marrow Biopsy: To look for the classical signs of ET or to rule out the early phase of Myeloproliferative Neoplasm a Bone Marrow Biopsy is performed.

Gene mutation studies: Your doctor would recommend a gene mutation test that studies JAK2 mutations, CALR or MPL mutations.

Treatment

If you are asymptomatic, you may not require any medication for ET. Others may require several treatments and therapies, to get symptomatic relief.

Available treatment options include:

Low-Dose Aspirin: Your doctor might prescribe you a low dose of aspirin to reduce the risk of blood clots and to relieve you from the burning sensation in the hands and feet that are caused due to ET.

Hydroxyurea: If you are in the category of patients who require treatment with drugs, your doctor will prescribe you hydroxyurea as a first-line agent. It reduces the risk of blood clotting.

Anagrelide: If you are the one who is intolerant to hydroxyurea, then your doctor would prescribe a platelet-lowering drug called Anagrelide.

Interferon: If you are a pregnant woman with ET, then your doctor would prescribe interferon for treating ET.

Lifestyle modifications

Apart from taking regular medications, you must also try to inculcate certain healthy habits into your daily routine, such as the following tips:

• You must eat healthy foods that should include whole grains, fresh fruits, and vegetables. Your diet should be low in saturated fats. You must avoid trans fats.
• You must increase your physical activity. Try to take a brisk walk ride your bike or swim.
• You must keep your weight in control because being obese increases the pressure on the pelvic veins and legs, which can be the risk factor for High Blood Pressure.
• You must quit smoking and avoid alcohol consumption

Signs and symptoms

The Mediterranean Fever symptoms usually occur during childhood and they occur as attacks or bouts that last for one to three days. Signs and symptoms include:

• Fever
• Pain in the abdomen, joints, chest, and muscles
• A red rash on the lower limbs, especially around the knee or ankle
• Painful scrotum
• Deposits of an abnormal protein (amyloidosis) can also occur in organs such as Kidneys, Liver, Thyroid Gland, Heart.

Causes

FMF is a familial genetic disease, caused by an abnormality in the MEFV (Mediterranean Fever) gene. Parents having this abnormal gene can inherit it from their progeny, and hence the offspring is born with the illness. For a child to acquire FMF, he/she should inherit two abnormal copies of the gene - one from each parent.

The abnormal MEFV gene reduces the activity of pyrin – a protein responsible for controlling inflammation in the body. Derangement of pyrin causes uncontrolled inflammation, leading to fever and pain in the affected areas.

Risk factors

Having any one of the following may increase your risk of developing FMF.

• Descendent of the Mediterranean region
• Family history of the disease

Complications

In the long run, patients with FMF can develop Arthritis, Renal Failure, and infertility in women, as abnormal clusters of protein accumulate in various body tissues.

Diagnosis

FMF is diagnosed by genetic testing/ DNA test. But, the need for diagnosis is felt only if the person has periodic episodes of fever associated with severe abdominal pain, and/or chest pain, and/or joint pain lasting for more than 2 days.

However, few laboratory findings such as an increase in the number of white blood cells, high Erythrocyte Sedimentation Rate (ESR), and elevated serum levels of fibrinogen are characteristics of FMF.

Treatment

FMF is incurable. But few Mediterranean Fever treatment options can prevent signs and symptoms.

Prophylaxis (prevention) of FMF is done by taking colchicine. Regular consumption reduces the recurrence of fever and other symptoms.

However, an already-started episode of FMF can be managed by taking pain relievers such as paracetamol or dipyrone to control pain and discomfort.

Evaluation of close-ones

Irrespective of the symptoms, all the first-degree relatives of the patient should take a genetic test, to detect the presence of p.Met694Val Allele. The presence of a mutant form of this gene may result in amyloidosis. For such individuals, colchicine can be given as it prevents Renal Amyloidosis.

Causes

The exact cause of Fibromyalgia is still under wraps. Mostly it is triggered by

• A physical or emotional stressful situation or event
• Accident or repetitive injuries
• Infection or illness may also trigger or aggravate Fibromyalgia.
• It is found to run in families.
• Genes along with conditions like Arthritis, spine disorder, and stress, trigger Fibromyalgia.
• Changes in neurotransmitters (Brain chemicals) may also cause Fibromyalgia.
• People with Fibromyalgia may have low levels of serotonin which affects mood, and sleep, and reduces the perception of pain.
• They have high-level substance P, which delivers pain messages to the Brain.
• Abnormality in the autonomic nervous system releases a hormone that affects the way a person perceives pain.
• Lack of sleep also tends to aggravate Fibromyalgia.

Symptoms

Fibromyalgia is a syndrome rather than a disease. A syndrome is a group of signs and related medical conditions that occur together, but are not related to any specific identifiable cause. In addition to pain in the tender points and fatigue, other medical conditions and Fibromyalgia symptoms are:

• Pain gets worse with any activity or stress
• Deep ache or burning sensation in the tender points
• Muscle tightness or spasms
• Lack of sleep or Sleep disturbances
• A memory problem called“fibro fog”
• Headaches & jaw pain
• Morning stiffness
• Lightheadedness or difficulty balancing
• Dry eyes or difficulty focusing on nearby objects
• Numbness or tingling
• Itchy or dry skin
• Irritable Bowel Syndrome
• Chronic Fatigue Syndrome
• Restless leg syndrome
• Depression & Anxiety
• Post-traumatic Stress Disorder
• Osteoarthritis
• Sensitive to temperature, loud noise, and bright light
• Chest pain, rapid or irregular Heartbeat, and shortness of breath
• Digestive problems
• Urinary issues
• In women, pelvic pain, pain during menstruation, and pain during sex

Diagnosis

Diagnosing people with Fibromyalgia is quite difficult because the main symptoms of Fibromyalgia, pain and fatigue, most of the time overlap with other medical conditions. Therefore, doctors have to rule out the presence of other associated conditions before diagnosing Fibromyalgia.

And secondly, there is no specific laboratory test to diagnose Fibromyalgia. Standard lab tests fail to find the exact reason for pain. However, a doctor experienced in diagnosing Fibromyalgia may diagnose Fibromyalgia based on the pain and tenderness in the tender points.

According to the American College of Rheumatology (ACR), there are 18 tender points in our body to meet the diagnostic criteria, a patient with Fibromyalgia should have at least 11 tender points (this is not always correct as men are not this tender).

Symptoms and associated syndromes form the main criteria for diagnosis. While diagnosing, the focus should be on the features of the pain to differentiate it from Arthritis pain. For instance, Hypothyroidism and Polymyalgia Rheumatic (aching and stiff joints in older people) resemble Fibromyalgia.

In such conditions, the doctor may perform a blood test to check the level of Thyroid Stimulating Hormone (TSH) and Erythrocyte Sedimentation Rate (ESR) to distinguish Fibromyalgia.

Treatment

Fibromyalgia does not cause any permanent damage, and although the symptoms may include pain and tenderness, it does not damage any of the body muscle and is not life-threatening. There is no complete cure for Fibromyalgia, but the symptoms can be minimized to feel better.

On approaching a doctor, he might first go with a painkiller and medicine that improves sleep. Drugs such as acetaminophen and non-steroid anti-inflammatory drugs (NSAID) are prescribed. NSAIDs are ineffective when taken alone. If the patient is depressed, the doctor may also prescribe anti-depressant drugs like tricyclic antidepressants, selective serotonin reuptake inhibitors, and mixed reuptake inhibitors.

Benzodiazepine drug helps patients with Fibromyalgia to relax the painful muscles and stabilize the irregular waves that interfere with proper sleep.

Physical therapy and counselling may be necessary for patients to regain muscle strength, reduce pain, and cope with the disease.

Other things that the patient can follow for Fibromyalgia treatment to feel better are:

• Do low-aerobic exercises like swimming, water exercise, stationary cycling etc
• Cut out stress
• Get peaceful sleep for as much time as required
• Do not take alcohol and caffeine as they interfere with sleep
• Maintain an equal level of activity every day
• Schedule time for eating, sleeping, and exercising
• If depressed, contact a therapist who will teach you to cope with the disease

Outlook

A patient with Fibromyalgia can still lead a normal life and can enjoy doing every activity that a non-Fibromyalgia person does. A few things that a Fibromyalgia patient should take care of are – scheduling his rest time, exercising as much as required, eating on time, and knowing more about the disease and its management. Along with therapeutic options, self-management is an integral part of coping with Fibromyalgia, which significantly improves symptoms and daily function.

Benefits of Folic Acid 

Folic acid has several benefits. A few of them are mentioned below:

• Preventing and treating low blood levels
• Used for memory loss
• Use to prevent Heart Disease
• Prevent miscarriage and birth defects
• Prevent hearing loss
• Prevents depression
• Treats Anaemia
• Used for Kidney Diseases
• Used in the treatment of iron deficiency

Folic acid side-effects

Folic acid also has a few side-effects which are mentioned below. High folic acid dosage causes:

• Abdominal cramps
• Diarrhoea
• Rash
• Sleep disorders
• Irritability
• Confusion
• Nausea
• Upset Stomach
• Behavioural changes
• Seizures

Signs and symptoms

Due to Anaemia, you may have weakness and fatigue. Other folic acid deficiency symptoms are:

• Loss of appetite
• Weight loss
• Grey hair
• Depression
• Diarrhoea
• Poor growth
• Headache
• Irritability

Causes and risk factors

The primary cause of folic acid deficiency Anaemia is malnutrition. Malnutrition occurs due to having a diet low in vitamins and having overcooked foods. The inability to absorb folic acid in the body by the Intestine (malabsorption) can also lead to folic acid deficiency Anaemia. In women, pregnancy also causes folate deficiency Anaemia.

Excessive alcohol intake and a history of Sickle Cell Disease also increase the risk of Folate Deficiency Anaemia. Alcohol interferes with the folate absorption in the body.

Complications

If you have folate deficiency Anaemia during pregnancy, your baby may develop Congenital Birth Defects such as Spina Bifida. Spina Bifida is a condition in which the backbone and membranes around the spinal cord are closed.

Diagnosis

Other conditions of blood also have similar symptoms. So, your doctors recommend for few diagnostic tests to rule out other conditions and confirm the diagnosis. The diagnosis of folate deficiency Anaemia includes:

• Complete Blood Count to determine Red Blood Cell count
• Red Blood Cell folate level test to determine folic acid levels

Your doctor may also question your eating habits to determine whether malnutrition is a cause of Anaemia. If you are of childbearing age, your doctor orders a pregnancy test to determine whether the pregnancy is the cause.

Treatment

The goal of the treatment is to treat the underlying cause and increase folic acid levels.

Your doctor prescribes folic acid tablets to be taken every day till the folic acid levels reach the normal range. If the levels are too low, your doctor prefers administration of folic acid intravenously. If your intestine is failing to absorb folic acid, you may need folic acid supplements for a lifetime.

If the cause is malnutrition, your doctor advises you to make dietary changes to increase the intake of folic acid. Consuming green leafy vegetables, citrus fruits, yeast, Liver, beetroot, and sprouts may help you to recover from folate deficiency. Consume fresh foods and avoid processed or overcooked foods. Your doctor may refer you to a dietitian to make a proper diet plan.

You will recover from this condition after the treatment with no chronic side effects.

Self-management

Taking folic acid supplements if your folic acid levels are low can reduce the risk of developing Anaemia. During pregnancy, take folic acid supplements as per your doctor’s advice.

Consume dark green leafy vegetables as these foods are rich in folic acid.

Types of Gangrene

Dry Gangrene: Dry Gangrene is caused when your body part does not get sufficient oxygen, this makes the part deteriorate and finally die. Dry Gangrene does not have a chance of infection.

Wet Gangrene: When bacteria invade the organ, wet Gangrene occurs; there can be moisture due to the presence of bacteria which makes the tissue die. Wet Gangrene is considered more serious than dry Gangrene because of the chances of spreading the infection to other parts of the body.

Shortness of breath, feeling of vomiting, and a sudden episode of heavy cold sweating are the other coronary artery disease symptoms.

Gas Gangrene: Clostridium perfringenis bacterium is the main cause of gas Gangrene. The bacteria cause gas bubbles and toxins inside the affected area and the toxic gasses cause tissue death. This is a fatal type of Gangrene.

Causes and Risk Factors

The following conditions are the risk factors that can cause Gangrene

• Habits such as smoking
• Infection to the wounds
• Conditions such as Obesity
• Certain drugs such as warfarin
• Diseases such as Raynaud’s Syndrome, and Diabetes
• Injuries such as crash injury, frostbite or severe burns
• Certain diseases that affect blood circulation (Arteriosclerosis)

Symptoms

The signs and symptoms of Gangrene may include:

• Discoloration of skin
• Foul-smelling discharge from the sores
• Partition between healthy and damaged skin

If the Gangrene affects your internal organs, then you are likely to experience the following symptoms:

• High body temperature
• Swelling and pain near the site

If there is any bacterial infection near the gangrenous tissue, you may experience shock; the signs and symptoms of shock include:

• Low Blood Pressure
• Confusion
• Lightheadedness
• Increased Heart rate
• Difficulty in breathing

Notify your doctor immediately when you experience symptoms such as persistent fever, skin discolouration, numbness or hard feeling near the skin, or sudden, sharp pain at the surgery or trauma site.

Complications

Gangrene is a medical emergency if the Gangrene is infected with bacteria. The bacterial infection spreads to other organs and can cause serious complications if left untreated.

Gangrene may lead to scarring and may require the need for reconstructive surgery. At times when tissue death (necrosis) occurs, the body part such as the foot may need amputation.

Diagnosis

Your doctor may order a routine blood test to evaluate your White Blood Cells (WBC), if the WBC is found elevated, it indicates the presence of infection.

Your doctor would order imaging tests such as X-ray, (CT) Computerized Tomography Scans or (MRI) Magnetic Resonance Imaging Scan to view the interior body structures and to analyze the severity of Gangrene.

Your doctor may order for an Angiogram to view your arteries, this test helps to evaluate the presence of any blockage in your arteries.

Your doctor may order for tissue culture, this involves the extraction of fluid from the blister present on your skin and is then examined for the presence of Clostridium perfringens.

Treatment

The treatment for Gangrene depends upon the type and severity of Gangrene. Your doctor would choose the best treatment strategy for you; the main goal of the treatment is to prevent further complications such as amputation. The following treatment options are considered:

An intravenous antibiotic - if there is any evidence of bacterial infection

Vascular Surgery is if you have improper blood flow due to the blocks in the arteries. This surgery helps in improving the blood flow through the veins to the tissues.

Hyperbaric oxygen chamber - this is considered if the type of Gangrene is Gas Gangrene. It helps in halting or slowing down bacterial growth due to the presence of an oxygen-rich environment. This fastens the tissue healing and also provides oxygen supply to the damaged tissue and promotes healing.

Tissue debridement - to remove the dead tissue. It is performed with surgical tools and chemicals. The benefit of this treatment option is that it removes the infected tissue and prevents further spread.

Skin graft - to replace your damaged tissue in the case of severe Gangrene. In many cases, amputation of the affected limbs such as the toe, and the finger is necessary. In essential cases, the parts may be fitted with a prosthesis, or with artificial limbs to replace the removed body part.

Transmission and Causes

Genital Herpes is a sexually transmitted infection that spreads through close contact with an infected person, mostly during sexual contact. The virus gains entry into your body through a break in the moist skin of the penis, vagina, cervix, urinary opening, or anus during vaginal, oral, or anal sex. Genital Herpes are known for the sores that they cause near lips, genitals, and anus. Direct contact with these sores also spreads the infection.

HSV-2 infection spreads through sexual contact or skin-to-skin contact with a person who is already infected, regardless of the fact whether or not he has an open sore.

HSV-1 infections of the genitals are seen as fever blisters or cold sores in and around the mouth and lips and spread during oral-genital or genital-genital contact with an infected person. Apart from the genital organs, the Herpes virus also affects your mouth, lips, tongue, eyes, gums, and fingers. You can infect yourself, if you touch the sore and then rub or scratch any other part of your body, especially your eyes.

People at risk

Anybody who is sexually active can be infected with herpes virus. People who have unprotected sex, and who have more than one sex partner are at greater risk. About 16.2% (one out of six) are affected with HSV-2 infection. HSV-2 is more common in women between the age group 14-49 years than in men within the same age group. Transmission is most likely from an infected male partner to his female partner than vice versa.

After the virus enters…

Once the virus gains entrance into your body you may face many stages of infection.

• Primary stage: This stage starts 2 to 8 days after infection. You will notice a small group of painful blisters near your genital region. The blisters are filled with clear or cloudy fluid that breaks open and becomes open sores. Sometimes you may have fever and other flu-like symptoms. Most people do not experience any of these symptoms and may not even have the slightest hint that they are infected.
• Latent stage: During this stage, you will have no symptoms as the virus is busy travelling from your skin to the nerves near your spine.
• Shedding stage: Again a non-symptomatic stage where the virus multiplies in the nerve cells and starts invading the saliva, vaginal fluid or semen.
• Recurrences: The blisters and sores come back after the first attack. But the symptoms are not as bad as it was in the first attack.

Symptoms of Genital Herpes

Genital Herpes does not show any signs or symptoms. Someone who is infected might never show any sores. However, if signs and symptoms show up they are well noticed. You may experience the following signs. They are:

• Pain and itching followed by soreness in the buttocks, vagina, scrotum, penis, and anus. The sores usually disappear within 2 to 4 weeks.
• If the sores are open, they could be oozing out with fluid or blood from the sore.
• It could be painful to urinate, along with tenderness and pain in the genital area.
• Some people may also have flu-like symptoms, which cause fever, chills, fatigue, headache and swollen lymph nodes.
• There could be pain in the lower back, thighs, buttocks, or knees.
• In recurrent infection, the symptoms are milder and the sores disappear faster.

If you notice or suspect any of these symptoms contact your doctor for a proper diagnosis as many other complications also result in such similar symptoms.

Diagnosing and treating Herpes

Herpes virus can be diagnosed using the sample taken from the sores, which are later cultured to check the growth of the virus. A positive test confirms Herpes but a negative test does not rule out the presence of the virus. A blood test is done to detect the presence of antibodies that are produced against the virus.

Genital Herpes cannot be cured. The virus remains in the latent stage in the nerve cell and wakes up if something triggers it like – stress, illness, surgery, monthly periods, vigorous sex, and diet.

Medication, of course, can help you a lot. Medicine like acyclovir reduces the pain and heals the sore faster. It also lessens the number of recurrences. These are the herpes simplex virus treatment. Acyclovir creams are available that can be applied to the sores. Recurrence of Herpes is treated by famciclovir and valacyclovir. In severe cases, hospitalization and intravenous medications are necessary.

Pain is a troublesome symptom of Herpes. To soothe the pain caused by infection you need to follow certain tips

• Taking an aspirin, acetaminophen or ibuprofen can help reduce pain
• Keep lukewarm water on the sore or take a bath in lukewarm water
• Clean the affected area and dry it properly
• Wear loose cotton underwear
• If blisters are broken wash the area with mild soap and water

Sex during infection

Being diagnosed with Herpes gives a feeling of guilt and shame. You may be disappointed as your complete sex life is ruined, but remember you are not alone in fighting Herpes; there are millions of people struggling with it every day. If you are infected with Herpes inform your partner and have safer sex – use condoms. But the fact is no time is safer to have sex if you are infected because unknowingly you might spread the infection to your partner. Avoid sex if you have sores, as sores invite the AIDS virus. Remember, using a condom only reduces the risk of spreading but does not give 100% protection.

Genital Herpes and Pregnancy

Herpes infection during or before pregnancy should be discussed in detail with your healthcare provider as you may pass the infection to your unborn baby, which can cause Brain injury or even death. Your baby is safe until it is in the uterus, but during delivery, it has to pass through the birth canal that harbours the virus. Contact with the virus will infect your newborn too. Therefore, you must inform your doctor in advance so that he might decide on a cesarean delivery.

Coping with Genital Herpes

Don’t be disheartened if you have Genital Herpes, talk to your doctor as there are millions out juggling with the same. There are many support groups which would like to educate you and help you carry on with a normal life. Manage your stress and live a healthy life, which will help you to cope with the condition.

Genital Warts and their Occurrence

Human Papillomavirus (HPV) causes Genital Warts. Genital Warts are small, supple and skin-colored protrusions. In women, Genital Warts can grow on the external genital organ (vulva) and the genital area between the vulva and anus, on the cervix (opening to the womb or uterus) and in the vagina (sheath leading to the uterus). In men, Genital Warts may grow on the penis, near the anus and on the area between the penis and scrotum (the muscular sack that holds the testicles). HPV infection sometimes may cause Cancer (uncontrolled growth) of the vulva, penis and anus.

Causes

HPV is a type of Sexually Transmitted Disease (STD) which may be transmitted through oral, vaginal or anal sex with someone who is already infected with HPV. The infection may take a long period to develop from the time the person is infected and as such the Genital Warts do not show up immediately, and this means that the person may not be free of HPV, though there are no visible signs. In women, the Genital Warts may be present in the areas where they cannot be seen explicitly.

Symptoms

Genital Warts are transmitted through sexual contact and the warts are not usually visible. They may be very small and the color may differ. They may feel smooth and bumpy on the skin.

Genital Warts in males may appear in the following areas:

• Penis
• Scrotum
• In and around the anus
• Thighs
• Groin

Genital Warts in males may appear in the following areas:

• Inside the vagina or anus
• Outside the vagina or anus
• Cervix

Even though the warts are not visible there are a few symptoms which will be observed:

• Vaginal discharge
• Itching
• Bleeding
• Burning sensation

Diagnosis of Genital Warts

In men, Genital Warts are diagnosed by the doctor through physical exam. Sometimes, the doctor may need to take a sample tissue of the genital wart to check whether the lesion is a genital wart or not.

In women, a pelvic exam is required to check for any irregularities associated with Genital Warts and a Pap (cervical smear) test. There may be a need to check with a colposcope through which vaginal walls and cervix are microscopically examined for any abnormalities.

Treating Genital Warts

Genital Warts must be treated by your doctor. Do not resort to self-treatment. The viral infection can never be removed once you are infected. That is why even though the warts are removed, HPV continues to stay in your body, and as such the warts may reappear.

Your physician may use one of the following methods to remove Genital Warts.

• Cryotherapy: The warts are removed or destroyed by freezing them with liquid nitrogen.
• Chemicals: Special chemicals such as trichloroacetic acid are used to remove the Genital Warts. This chemical dissolves the warts and may need to be applied several times over several weeks.
• Electrocautery: Electricity is applied through special instruments to cauterize and remove the Genital Warts.
• Laser (Light Amplification by Stimulated Emission of Radiation) Therapy: When the warts are extensive and all other treatments become ineffective in removing the Genital Warts, then they are vaporized using laser therapy.
• Loop Electrosurgical Excision Procedure (LEEP): In this procedure, a thin, low-voltage electrified wire loop is passed around the base of the wart to cut it off from the skin.

If you do not get the wart treatment done, there is a risk of these Genital Warts growing further. You may pass on the HPV infection to your partner. If these Genital Warts are on your cervix, they may grow abnormally and could become Cancerous. Untreated Genital Warts can cause the Cancer of vulva, vagina, anus and penis.

Do not neglect Genital Warts

HPV is very common and can be treated. You need not become embarrassed if you notice any Genital Warts. Consult your doctor who can help you with proper treatment for warts to remove them. If you do not resort to treatment, there are chances that you pass on the HPV infection to your partner or the untreated HPV infection may lead to Cancer.

Symptoms

The symptoms of Swine Flu develop 3 days to 5 days after the person has been exposed to the H1N1 Virus. The affected person has the following H1N1 symptoms:

• Sore throat
• Cough along with high fever and chills
• Body ache
• Headache
• Vomiting
• Diarrhoea
• Fatigue

One must consult the doctor immediately if one experiences these signs:

• Shortness of breath
• Feeling of confusion

In children, the parents must look out for warning symptoms like,

• Fever associated with rash
• Extreme irritability
• Symptoms of flu that keep appearing and disappearing
• Inability to drink fluids
• Difficulty in waking up from sleep

In case of Swine Flu during pregnancy or any underlying health condition like Heart Disease or Eemphysema, one needs to consult the doctor.

Difference between H1N1 Flu and Seasonal Flu

Seasonal flu is also caused by viruses like Swine Flu but it appears during December, January and February, unlike Swine Flu which appears in spring.

Seasonal flu infects people who are 65 years of age and above as HINI flu occurs in people who are below 25 years of age.

Diagnosis

For diagnosing Swine Flu, a respiratory mucus sample is collected from the patient within 4 to 5 days of illness. This is the time when the patient sheds the virus.

In children, however, the shedding of the virus continues for more than 10 days. This sample is sent to the laboratory for testing.

Treatment

Treatment is not necessary for most of the H1N1 cases as they decrease on their own, but in case the patient has a chronic respiratory disease, medications are prescribed to clear Lung secretions, open the airways and decrease swelling.

In case of fever and body aches, medications like acetaminophen (Tylenol), Ibuprofen(Advil, Motrin) and Naproxen(Aleve) are taken. Anti-viral drugs like zanamivir (Relenza) and Oseltamir (Tamiflu) are prescribed only for people who have a high risk for complications to develop.

The high-risk group includes:

• Women who are pregnant
• Children younger than 5 years of age
• People 65 years and above age group
• Severe shortness of breath
• People who are hospitalized
• People with underlying medical conditions like asthma, Heart Disease, Diabetes, Kidney Disease, Liver problems, Blood Disease, Emphysema and Neuromuscular Disease, HIV infection
• Patients younger than 19 years of age who are taking long-term aspirin therapy

Vaccination

The H1N1 vaccination not only protects against Swine Flu but also against two strains of seasonal flu. The Centre for Disease Control And Prevention recommends the vaccination for high-risk groups that include,

• Pregnant women
• People who live and take care of children who are below 6 months
• People between the age groups of 6 months to 24 years of age
• People with chronic health problems and immune diseases
• People who work in hospitals and emergency services.

However, the H1N1 Swine Flu vaccine can be taken by anyone above 6 months of age for protection against the H1N1 Virus. Some people have however experienced allergic reactions after taking the vaccination.

Preventive measures

To prevent getting infected with the H1N1 Virus, one must always wash hands with an antiseptic soap or a hand sanitiser before eating meals.

The flu virus is said to survive on door knobs and countertops for nearly 2 hours. Washing of the hands is essential.

If a person has Swine Flu he or she should stay at home as the flu spreads to others easily.

While coughing or sneezing, the affected person should use a tissue to prevent contaminating surfaces with the infected droplets from the nose and mouth.

The affected person’s glasses and utensils have to be kept separately.

Causes of Halitosis

The various causes of bad breath are:

• When you eat foods, they break down in the mouth, and microorganisms can grow over it causing bad breath.
• Pungent foods like garlic, onion, certain spices and vegetables also cause bad breath.
• After the pungent foods are digested the pungent oils in the food are carried to the Lungs through the bloodstream from where they are expelled through breath.
• If proper oral hygiene is not maintained a thin film of bacteria called plaque develops on the teeth and gums which results in unhealthy gum enlargement known as Gingivitis.
• If proper brushing and flossing are not done, the bacteria in the oral cavity act on the particles of food remaining in your oral cavity to emit a foul-smelling odour of hydrogen sulphide which causes Halitosis or bad breath.
• If the tongue is not cleaned properly, the bacteria on its uneven surface produce a bad odour. In people who wear dentures or false teeth, it is very important to keep the dentures clean as bacteria can multiply on them and cause bad breath.
• Halitosis may also occur in conditions called dry mouth or Xerostomia where there is a decrease in the production of saliva, as saliva regularly washes out the microorganisms from the mouth.
• Certain diseases also cause Halitosis. In conditions like Diabetes, Liver failure, Kidney Disease, Cancer and acidity you will find Halitosis.
• Medications that are used for Urinary Tract problems, High Blood Pressure and psychiatric conditions cause Halitosis by decreasing saliva production causing dry mouth.
• In conditions like Tonsillitis or enlargement of tonsils due to infection, sinus problems, ulcers and infections of the Respiratory System, impacted (unerupted) wisdom tooth, defective formation of cleft palate and oronasal cavity there is Halitosis.
• Bad breath is also seen in smokers. The tobacco smoke dries up the mouth causing bad breath. It also leads to Periodontal Disease (gum disease), a major cause of Halitosis.
• Consuming alcohol also causes bad breath as alcohol dries up the mouth and also causes digestive problems which ultimately lead to Halitosis.

Treatment

A regular visit to the dentist is a must for a complete oral check-up. If your dentist finds that you have plaque, and calculus which is the hardened form of plaque containing food debris, bacteria and mineral salts, then the dentist will recommend professional cleaning which is called Oral Prophylaxis or Scaling. This is one of the bad breath treatments.

In this procedure, the odor-causing plaque, calculus and stains are removed from the surface of the teeth, above and below the gums.

The dentist will also check for any faulty restorations that are harbouring odor-causing bacteria. They have to be replaced immediately.

Mouth rinses containing chlorhexidine, cetyl peridium, chloride, zinc and chlorine dioxide as ingredients are found to be very effective against odour-causing bacteria.

Antibacterial toothpaste is recommended by the dentist to fight against these bacteria.

Preventing Halitosis

You can follow certain steps to prevent Halitosis. The bad breath remedies are:

• Brush your teeth twice a day with a good antibacterial toothpaste. It is important to change your toothbrush once in 3 to 4 months and remember to use a soft bristle brush that is soft on the gums. Use a tongue scraper to remove the dirt and bacteria prevailing on the tongue.
• Use an antibacterial mouth rinse that is effective against odor-causing bacteria. To clean plaque between teeth, flossing needs to be done every day in which a floss or thread made of nylon is passed between the teeth to remove plaque.
• It is also essential to keep your tongue clean. Use a tongue scraper or brush with a scraper behind its head to clean your tongue.
• Cleaning your dentures daily is also essential as they harbor odor-causing bacteria.
• Drinking lots of water will prevent dry mouth or xerostomia. If that does not solve the problem, then the dentist will give you saliva-inducing oral medication.
• Avoid pungent foods and include fibre in your diet.
• Visit your dentist at least twice a year for regular checkups. If Halitosis is due to a reason other than oral hygiene, consult your general physician. Follow these preventive steps for bad breath solutions.

Keep Halitosis away

The problem of Halitosis is not a new one. Evidence shows that around 5000 BC, the Egyptians made their toothpaste with pumice, ash of egg shells, hooves of ox and myrrh. Interestingly, in 50 AD, Greek scholar Pliny suggested using worms and toads to relieve bad breath.

The history of a toothbrush also dates back to ancient Egypt where they made tooth-cleaning tools with twigs. Fortunately, in today’s times, we have developed good oral hygiene methods by which we can keep Halitosis away.

Remember to take good care of your oral hygiene, as a beautiful smile and fresh breath can win over more people than you can ever imagine!

Causes

The chance of getting a heat rash is very common in hot humid weather, when a person sweats a lot. Too much sweat gets trapped under the skin and blocks the sweat gland. The blocked pores do not clear out the sweat and result in rashes.

The rash formation is triggered by – sweating too much, having a high body temperature, being overdressed or being in a warm environment for a long time.

Babies wrapped closely in warm clothes and people who are not used to hot weather are more likely to get heat rashes. However, the exact reason why sweat glands block is unknown. Some predicted reasons are

• Immature sweat duct in babies
• Excess physical activity
• Hot and humid climate
• Thick fabrics
• Few perspiration medicines
• Heating the body too much by sleeping under an electric blanket and bundling in too many clothes
• Excess creams and ointments can block the sweat glands
• Fever and bedridden for a long time

Symptoms

Heat rashes are more likely to appear in the region where there are folds of skin and skin touches another skin.

Regions like the neck, shoulder, upper chest, scalp (if wearing the hat continuously), groin (the region where the abdomen meets the thigh), the folds of the elbow, armpits, and under the Breast are mostly affected by heat rashes.

Heat rashes exhibit the following symptoms:

• Skin irritation
• Stinging sensation
• Red rashes
• Small red blisters or bumps
• Itching

The area affected may have little or no sweating.

In some people, it looks like skin-coloured lesions that appear like goosebumps. Lack of perspiration can result in:

• Dizziness
• Nausea
• Rapid pulse

The best time to consult a physician

In many, heat rashes go away on their own, but in case if they persist for more than 4 days or seem to get worse day by day then it’s time to consult a physician.

Physicians must be contacted if the rashes are too itchy, or are associated with pain and warmth in the affected region.

If heat rashes cause fever, swollen lymph nodes in the armpit, neck, and groin regions, and oozing of pus or fluid, then the doctor should be consulted.

Symptoms like dizziness, nausea, confusion, and trouble breathing should be dealt with seriously, as they might indicate severe heat-related illnesses like heat exhaustion and Heat Stroke.

Treatment

The most effective treatment for heat rashes is to keep the skin cool and dry.

Do not spend much time in a hot and dry environment, use the air conditioner, or fan to maintain temperature and circulate air.

The person can also use cool compressors in the affected regions. Keeping the affected region dry is very important after a bath drying under a fan helps dry the skin faster and avoid sweating.

Wearing clean, dry, loose, cotton clothes helps to avoid skin rubbing and irritation.

If the person has a fever, over-the-counter medicines like acetaminophen or ibuprofen can be taken.

Lotions may be prescribed only if the rashes are severe and irritation persists. Calamine lotion is prescribed for itchy skin; anhydrous lanolin helps to prevent the blockage of the duct and stops new lesions. Tropical steroids are recommended in more severe cases.

Prevention

Heat rashes can be prevented by following certain precautionary measures.

• In summer, one should wear loose-fitting, lightweight cotton clothes, and tight clothing should be avoided.
• Staying cool in hot climates by switching on the air-conditioner or fan may also help.
• Sleeping in a cool ventilated room is another method to keep oneself cool.
• Children should be allowed to play in cool shady places.
• Drinking plenty of water will help avoid Dehydration.

Regulation of body temperature

In human beings, it is vital to maintain body temperature within the range of 36.50C to 37.50C for normal functioning of the cells, and enzymes in the body even in unfavourable environmental conditions. The Autonomic Nervous System, the network of nerves that control certain bodily functions automatically independent of the Brain, regulates the body temperature.

The Hypothalamus, a part of the Brain, receives messages from the thermal receptors sensitive to the changes in the environmental heat via the Central Nervous System (Brain and Spinal Cord) and subsequently Hypothalamus responds to these changes by sending proper signals to the peripheral nerves (nerves outside Brain and spinal cord) for suitable action to be taken such as to conserve heat or to dissipate heat so that the body temperature is maintained within the “set-point” (36.50C to 37.50C).

Heat index

When it is hot outside and the presence of water vapour is also high (relative humidity) in the atmosphere, your body cannot sweat and cannot dissipate the heat which may lead to Heat Stroke.

The air temperature when taken along with the relative humidity is called the heat index which in simple terms indicates how hot it feels in the shade. A heat index of 900F or above is considered as dangerous.

Medicines that Affect Heat Stroke

Some of the medications affect the way your body responds to heat and may cause Heat Stroke.

• Antihistamines increase the susceptibility to Heat Stroke as they cause constriction of blood vessels, reduce sweating and may restrict the dissipation of heat
• The anti-stress hormone medicines (beta blockers) block the production of stress hormones leading to the constriction of blood vessels and thus may interfere with the regulation of heat in the body.
• Illegal drugs and diet pills can dehydrate the body and/or increase metabolism and heat production increasing the risk of Heat Stroke.
• Laxatives may cause excessive Bowel movement resulting in Dehydration and increased Heat Stroke risk.
• Medications for mental illnesses interfere with the regulation of the temperature and may restrict sweating leading to a rise in body temperature leading to Heat Stroke.
• Water pills cause the body to lose water and as such may cause Heat Stroke.

Your doctor shall be able to guide you accurately as to which medications you should avoid so that there is no increased risk of suffering from Heat Stroke.

Signs and symptoms

You should suspect heat exhaustion if you have normal or above normal body temperature but not more than 1040F with a headache, and a feeling of exhaustion, tiredness and weakness the skin may feel moist, sweaty and dank.

You may feel irritated and have an uneasy and unpleasant feeling in the Stomach. Your urine output may be reduced.

You may feel giddy due to decreased Blood Pressure while standing. Heat exhaustion may cause abnormal sweating, enlarged pupils, abnormal breathing patterns, and irregular Heartbeat.

The Heat Stroke symptom may be different in a Heat Stroke. The symptoms include:

• Body temperature may rise above 1060F in a very short time
• Dry and hot skin
• Narrowed pupils
• Deep and shallow breathing
• Rapid and strong/weak Heartbeat
• Initially High Blood Pressure subsequently lower than normal
• The sensation of the head swirling and the uneasy sensation of vomit
• Disorientation
• Painful muscle contractions

Things to do in a Heat Stroke situation

Following are the things to be done when faced with a situation of Heat Stroke.

• Call for medical emergency personnel
• Keep the person who had Heat Stroke in a cool place away from sunlight or from the source of heat such as in an air-conditioned room or shade.
• Remove unnecessary clothing from the body of the person with Heat Stroke and increase ventilation. Wet the skin of the person with cool water.
• If possible, arrange for ice packs and keep them in the areas where blood vessels are closer to the skin such as armpits, groin, neck and back.
• Monitor the temperature

Get medical help immediately if you observe any of the following emergency signs:

• Hot and dry but not sweaty skin
• Unconscious
• Severe vomiting
• Breathing problems such as difficulty in breathing or shortness of breath

If you are treated for heat exhaustion or Heat Stroke you will probably recover in a few hours to a few days respectively. You may become more sensitive to heat after heat exhaustion or Heat Stroke. Try to avoid further exposure to heat and follow the advice of your doctor till return to your normal activities.

Preventing heat-related illnesses

If the heat index is high, then it is advisable to stay indoors to prevent yourself from Heat Stroke. Engage in outdoor activities during the cooler part of the day. If you need to go outside, then avoid heavy, tight-fitting and dark-coloured clothes. Do not expose yourself to direct sunlight. Maybe you can wear a hat or umbrella. If possible, use a suitable sunscreen.

Ensure to take plenty of water as often as possible to avoid any loss of fluids. Try to avoid drinks that contain caffeine or other stimulants such as alcohol. While you carry out the outdoor activities, ensure to take water more often, say for every 15 minutes. Ensure to keep yourself properly hydrated all the time.

In case you have any other medical conditions and take medicines, discuss with your doctor how you can cope with the high heat index and what steps you need to take.

Cool it off!

Heat exhaustion and Heat Stroke are the two heat illnesses. Both need immediate medical attention. Though both are similar their symptoms differ. Heat exhaustion is the body’s inability to retain body fluids and salts. Heat Stroke, a bit different from heat exhaustion, is the body’s inability to maintain the temperature regulatory mechanism.

If proper precautions are taken heat illnesses can be prevented. When this occurs, immediate attention is required and both can be treated effectively. Recovery may take from hours to days depending on the severity of the heat illness.

Normal iron content in the body

Iron is a mineral found in many food items that play a vital role in the body. Normal iron content in an individual’s body is three to four grams. There is a loss of about 1 mg of iron daily from sweat and cells that are shed from the skin and the inner lining of the intestines.

In a normal adult, the intestines absorb 1 mg of iron daily from food to replace the lost iron, and therefore, there is no excess accumulation of iron in the body. If there are excess iron losses from the body, more iron is absorbed from food.

Hemochromatosis: Know the condition

An individual is said to suffer from Hemochromatosis when there is too much iron buildup or iron overload in his/her body. It is one of the most common inherited disorders, in which the daily absorption of iron from the intestines is greater than the amount needed to replace losses even in the absence of excess iron loss. Since the normal body cannot increase iron excretion, the absorbed iron accumulates in the body.

Over many years, iron accumulates to toxic levels that can damage or even destroy an organ. This excess iron is seen to be deposited in the joints, Liver, testicles, Liver, Brain, and Heart. Iron overload in the pancreas can cause a form of Diabetes that is often resistant to insulin treatment and is called “Bronze Diabetes."

Too much iron in the Heart can lead to Arrhythmias/irregular Heartbeats. Excess iron in the Liver can cause an enlarged Liver, Liver failure, Liver Cancer or a condition called Liver Cirrhosis in which there is scarring of the Liver that prevents it from working properly.

Causes

Primary Hemochromatosis is the most common type of disease and runs in families. It is caused by a defect in the genes (HFE genes) that are responsible for controlling how much iron you absorb from food. These faulty genes cause the body to absorb too much iron.

A person is at risk of iron overload and can have signs and symptoms of the condition if he/she inherits two copies of the faulty gene (one from each parent). A person may only inherit one faulty gene from one parent. In that case, he/she would become a Hemochromatosis carrier who will not develop the disease but is capable of passing it on to their children.

Secondary Hemochromatosis is seen to occur in an individual due to the presence of another underlying disease condition that can cause iron overload. A few such conditions are certain types:

• Anaemia (Thalassemia and Sideroblastic Anaemia)
• Atransferrinemia and Aceruloplasminemia (inherited disorders)
• Chronic Liver Diseases such as Chronic Hepatitis C Infection, Alcoholic Liver Disease, or Non-alcoholic Steatohepatitis.

Other factors that can cause secondary Hemochromatosis are:

• Blood transfusions
• Oral iron pills
• Iron injections (with or without very high vitamin C intake that helps to absorb iron), and long-term Kidney Dialysis

Symptoms

Only half of the individuals affected with Hemochromatosis will show the signs and symptoms due to iron overload. The severity of the condition is seen to vary from person to person with some of them never having any complications despite high amounts of iron in their body. The condition is more common in men as compared to women and in older individuals as compared to younger people.

Women are seen to be less likely to develop symptoms of iron buildup probably due to normal iron loss during menstruation. Signs and symptoms may include:

• Joint pains
• Fatigue
• General weakness
• Weight loss
• Abdominal pain

Reproductive organ failure causes symptoms such as,

• Impotence
• Shrinkage of the testicles
• Loss of sex drive in men
• Absence of the menstrual cycle
• Early menopause in women
• Deposition of iron in the skin can make the skin look grey or bronze

Diagnosis

A detailed medical history (symptoms, intake of iron pills, vitamin C intake), family history of the condition, physical examination (irregular Heartbeats, Arthritis, abnormal skin colour, enlarged Liver etc.) along with certain tests and procedures can help in the diagnosis of the condition.

Blood tests are done to check for the level of iron in the body and the functioning of the Liver.

A Liver Biopsy (removal of a small sample of Liver tissue to examine under the microscope) to check for the amount of iron in the Liver may be done.

An MRI Scan (uses radio waves, magnets, and a computer to create pictures of your organ) may be done to show the amount of iron in your Liver.

Genetic testing may be done in certain individuals to show if they have the faulty genes for Hemochromatosis however it cannot predict if they will develop the signs and symptoms of the condition.

Treatment

Hemochromatosis treatment can be done effectively and safely by removing blood from the body regularly similar to donating blood. It is done to reduce the high iron levels to normal. The amount of blood drawn depends on your age, your overall health and the severity of iron overload. Initially, a pint of blood may be taken once or twice a week. Once the iron levels have returned to normal, blood may need to be drawn about four to six times a year.

If the individual cannot under the procedure of removal of blood then a medication that causes the body to expel iron from the blood may be prescribed. A doctor can inject the medication or else the individual can take it as a pill at home.

A few dietary changes that are recommended include avoiding iron supplements and multivitamins, avoiding red meat, abstaining from alcohol, and avoiding raw shellfish to prevent the increased risk of bacterial infection.

Types of Hemophilia

Three forms of Hemophilia include the following:

Hemophilia A: It is the most common type of Hemophilia that is caused by lack of clotting factor VIII. It is estimated that nearly eight out of 10 people with Hemophilia suffer from Hemophilia A.

Hemophilia B: It is also known as Christmas disease and occurs when the levels of clotting factor IX are deficient.

Hemophilia C: It is the mild form of Hemophilia and is caused by the deficiency of coagulation factor XI. Individuals with this type of Hemophilia may not experience spontaneous bleeding but may occur after a trauma or injury.

Causes

Your blood clotting mechanism called a ‘coagulation cascade’ is the process where your blood is converted from liquid to solid. The process also involves several clotting factors. When your blood is deficient in these clotting factors, blood cannot clot properly leading to continuous and severe bleeding.

Hemophilia and genetics: Hemophilia is considered to be an inherited disorder. However, if none of your family members suffered from Hemophilia, then it may occur as a result of spontaneous mutation. A mutation or a change in one of the genes that is responsible for the production of clotting factors can lead to Hemophilia. These genes are located on the X chromosome. Females have two X chromosomes and males have one X and one Y chromosome.

Each individual inherits two chromosomes each from mother and father. Males inherit one X chromosome from the mother and one Y chromosome from the father. Females inherit one X chromosome from the mother and one X chromosome from the father. If the mother has an altered gene on one X chromosome, then there is a 50 per cent chance of passing the genes to her children. If the female has an altered gene, then she is considered a carrier of Hemophilia. That means she can pass the disease to her children, but she is not affected by the disease. Because she has another healthy X chromosome that can prevent bleeding risks. If the male has an altered gene that is inherited from the mother, then he will have Hemophilia.

Symptoms

The severity of your symptoms depends on the levels of clotting factors. If the deficiency of clotting factor is very mild, then you may experience bleeding only after surgery or an injury. If you have a severe deficiency of the clotting factors, you may experience the following symptoms:

• Unexplained, large bruises
• Blood in the stool or urine
• Deep bruises
• Frequent nosebleeds without any cause
• Pain, swelling, and tightness in the joints due to bleeding
• Unexplained irritability in infants

You should immediately visit your doctor if you have any of the following symptoms.

• Sudden pain and swelling in the large joints
• Excessive bleeding from an injury
• Severe headache
• Continuous vomiting
• Neck pain and double vision

Complications

The complications of Hemophilia include the following:

• Deep internal bleeding and swelling
• Damage to the joints due to continuous bleeding
• Adverse reactions to the clotting factor therapy

Diagnosis

If the individuals have a family history of Hemophilia, it can be determined during the pregnancy if the fetus is affected by the altered genes of Hemophilia.

Your doctor diagnoses the condition through blood tests. A sample of your blood is examined for the levels of clotting factors and interpreted as below:

Treatment

Hemophilia has no cure. However, the severity of the symptoms can be reduced with certain medications.

• If you’re diagnosed with mild Hemophilia A, then your doctor prescribes a hormone called desmopressin which is injected into your vein. It can stimulate the clotting factors and control bleeding.
• If you’re diagnosed with moderate to severe Hemophilia A or Hemophilia B, your doctor might prescribe an infusion of recombinant clotting factor or the clotting factors obtained from donated human blood.
• If you have Hemophilia C, clotting factor XI is infused. Sometimes, your doctor prescribes plasma infusions to stop bleeding.

Self-management

Following are certain measures that would help you to avoid excessive bleeding and protect your joints:

• Exercise regularly.
• Avoid painkillers such as aspirin and ibuprofen as they can trigger bleeding.
• Avoid blood-thinning medications such as heparin, warfarin, and clopidogrel.
• Maintain good oral hygiene to prevent dental extractions that can cause severe bleeding.

Symptoms

Here are a few Shingles symptoms. They are:

• Burning sensation
• Itching
• Redness
• Inflammation
• Headache
• Improper vision
• Chillness
• Tiredness
• Fever
• Fluid-filled blisters
• Scaly lesions
• Painful inflammation
• Irritation at the site of Shingles

Treating of Shingles

Shingles cannot be cured. However, with the help of the symptoms, Herpes zoster treatment can be provided to the person associated with Shingles can be treated to decrease the severity, and period of suffering.

Your doctor may prescribe antiviral medications such as Acyclovir, famciclovir or valacyclovir. These medications should be taken within 72 hours of having Shingles.

To reduce the severity of pain and swelling, your doctor may also prescribe medications such as non-steroidal anti-inflammatory drugs (paracetamol, ibuprofen) for mild pain, for severe pains narcotic analgesics such as oxycodone and in some cases, corticosteroids (synthetic hormones – steroid medicines) such as prednisolone, hydrocortisone, methylprednisolone, cortisone or herpes vaccine may also be recommended.

To reduce itching and irritation associated with painful blisters, anti-itch lotions such as Benadryl or Caladryl may be applied.

Shingles and Postherpetic Neuralgia

Even when the rashes have disappeared, the pain can persist. This condition is called Postherpetic Neuralgia. It is a painful complication of Shingles (herpes virus) and affects the nerves and the skin.

The skin becomes more sensitive to changes in the temperature, touch, clothing or moving air. It can cause hurting pain so severe as to disturb sleep and appetite. Postherpetic pain prolongs long after the rash or blisters of the Shingles have disappeared.

The pain can last for months and years and the risk is increased with people older than 60 years of age.

For some people, there is no single treatment, and in some, it may take a combination of medicines to reduce the associated pain.

Your doctor may prescribe patches that can be applied to the affected area such as lidocaine patches to cause numbness and relieve the pain temporarily.

Some people may need opioid pain relievers such as tramadol, oxycodone or morphine and need to be discussed with your doctor for their use, as they can be addictive.

Your doctor may also advise you to take over-the-counter (OTC) medicines and creams such as capsaicin cream to get pain relief.

Neurotransmitters are responsible for the perception of pain and your doctor may recommend antidepressants such as nortriptyline and amitriptyline in smaller doses to annul the effect of these neurotransmitters.

The damaged nerves cause abnormal electrical excitement and to soothe these injured nerves, your doctor may prescribe anticonvulsants such as gabapentin, pregabalin and others.

Preventing Shingles

Since 2006, the varicella-zoster vaccine has been available. The vaccine can prevent the occurrence of Shingles in individuals above the age of 60. The vaccine can only prevent but not be used for the treatment of Shingles.

The following people should not be given the vaccine.

• Persons who are allergic to any components of the vaccine such as gelatin or neomycin antibiotic.
• People whose Immune System is weakened by HIV/AIDS, steroids, Radiation or Chemotherapy, Bone Marrow Cancer and Cancers of the Lymphatic System such as Leukaemia or Lymphoma.
• People who have Tuberculosis (infection caused by tubercle bacilli)
• Pregnant or planning to become pregnant women

Jingle not with Shingles

Chickenpox and Shingles both are caused by the same virus. But Shingles is not contagious. You cannot give Shingles to others if you have it, but others can contract Chickenpox from you if they have not been infected earlier.

Shingles can be prevented by taking the proper vaccine. If you are over 60 years old and have Shingles, you can make Shingles not jingle by taking proper medications as recommended by your doctor.

What is Cholesterol?

Cholesterol, a kind of lipid (fat), is a waxy fat substance found in all the cells of your body. Cholesterol is required by the body for proper growth and development, and to produce hormones. 25% of the cholesterol in your body comes from your diet and the remaining 75% is made by the Liver and other cells. Cholesterol enters your body when you eat foods rich in saturated fats such as eggs, milk and milk products, red meat and tropical oils such as coconut oil.

Types of cholesterol

Cholesterol is of two types. Cholesterol is carried in your blood in bundles of lipoproteins. As lipids are insoluble in blood, they are transported to the destination by lipoproteins which are complexes of proteins and lipids.

The good cholesterol is called high-density lipoprotein (HDL) and the bad cholesterol is termed low-density lipoprotein (LDL). HDL removes cholesterol from the blood and carries it to the Liver, and LDL carries cholesterol to various cells in your body. Too much LDL is bad for your body, whereas a high level of HDL is good for your body because it decreases the cholesterol level in the blood.

High cholesterol is unhealthy

A healthy body requires a healthy level of cholesterol, for many functions in the body. The body uses cholesterol for proper growth and development of nerves, tissues and secretion of hormones. However, too much cholesterol in the blood can lead to the deposition of fats in the form of plaques in the blood vessels that carry oxygen to various parts of the body (arteries) causing them to become narrow (atherosclerosis). These plaques can become large and block the flow of blood in the arteries.

When these plaques split up, they can cause blood clots which again obstruct the blood flow. If the arteries supplying the blood to the Heart are jammed, it may result in a Heart Attack. If the arteries that supply blood to the Brain are involved, then it may lead to a Stroke.

Causes of high cholesterol

High cholesterol is a major risk to Cardiovascular Diseases which causes a lot of health problems. Below mentioned are a few causes of high cholesterol. They are:

• High intake of saturated fat (deep-fried foods, dairy products, chocolate, meat)
• High intake of trans fat (some fried or processed foods)
• High cholesterol (meat, cheese, egg yolks)
• Overweight

The reason for abnormal levels of cholesterol can also be because of

• Diabetes
• Polycystic Ovarian Syndrome
• Liver or Kidney Disease
• Women during pregnancy develop high cholesterol levels
• Underactive Thyroid gland
• Drugs like progestins or steroids also increase cholesterol levels

Symptoms

People suffering from high cholesterol do not show any symptoms unless routine screening is performed. Routine screening includes regular blood tests. High cholesterol levels are not observed but eventually cause a threat of Stroke to the individual.

Checking cholesterol levels

You can undergo a blood test known as a lipid profile to check the levels of cholesterol in your blood. If you are a man and above the age of 35 yrs or if you are a woman above the age of 45yrs and having risk factors for other Heart Diseases, then you must check your cholesterol levels every 5 years. Otherwise, if you have any of the risk factors for Heart Disease, then you need to check your cholesterol level more frequently.

Elevated levels of cholesterol in the blood increase the risk of getting Heart Disease and or having Heart Attacks. Since there are no symptoms associated with high blood cholesterol or hypercholesterolemia, most people are not aware of this condition.

Total cholesterol level is the combination of various types of cholesterol and is measured in milligrams per deciliter (mg/dl) of blood. Total cholesterol of less than 200 mg/dl is considered normal, between 200 to 239 mg/dl is considered a borderline risk of cholesterol and 240 mg/dl and above is treated as a high cholesterol level and has double the risk of coronary Heart Disease than someone with less than 200 mg/dl.

An elevated level of LDL increases the risk of Heart Disease. LDL levels

• < 100 mg/dl is considered as most favourable
• 100 to 129 mg/dl is favourable
• 130 to 159 mg/dl is bad
• > 159 mg/dl means a very high risk of developing Heart Disease.

While a high level of HDL is considered safe and desirable,

• A low level of HDL offers no protection against build-up of plaques and clogging of arteries.
• > 60 mg/dl is most favourable,
• 40 to 60 mg/dl is favourable
• < 40 mg/dl is undesirable and has a higher risk of Heart Disease.

Improving your cholesterol level

Eat foods which are low in saturated fats so that you can reduce your LDL cholesterol. You can raise your HDL cholesterol by not smoking, and losing weight through exercises if you are obese or overweight. Besides resorting to healthy food habits, you have to make changes in your lifestyle by engaging yourself in regular exercise. If these do not work within six months to one year, you may have to consult your doctor for required cholesterol-reducing medications.

If your cholesterol levels are not controlled despite lifestyle changes from six months to one year, your doctor may prescribe some of the following medications.

• Statins: These drugs slow down the production of cholesterol and restrict the build-up of cholesterol in your arteries.
• Resins: The Liver uses cholesterol to produce bile acid for digestion. These drugs bind to the bile acid blocking its absorption and the unabsorbed bile acid is finally eliminated from the body. This makes the Liver produce more bile acid using more cholesterol finally resulting in the lowering of blood LDL cholesterol.
• Cholesterol inhibitors: These medicines block the absorption of cholesterol in the intestines and are given along with statins so that total blood cholesterol is maintained within limits.
• Niacin: This is a B vitamin and when given in large doses, increases HDL cholesterol and decreases LDL cholesterol. Follow the instructions from your doctor.

Manage cholesterol

High levels of cholesterol in the blood, mean a higher risk of Heart Disease. As you become old, cholesterol levels in your blood tend to rise together with associated risks. Generally, no signs or symptoms are manifested to warn you of high cholesterol. Hence, make it a point to undergo tests once every 5 years so that high cholesterol if any could be detected in time. Most importantly if any one of your family members already has a Heart Disease or high cholesterol or is obese or overweight.

Cholesterol can be reduced if you adopt a healthy lifestyle and healthy eating habits. Sometimes you may have to take appropriate medications to reduce your cholesterol.

Symptoms

Symptoms of HIV infection vary with the stages of infection as detailed below. HIV symptoms in men and HIV symptoms in women may not vary much.

Acute HIV: In the initial stages of the infection, called acute HIV infection, the patient may have early symptoms of HIV. The virus is rapidly dividing, during which the Immune System tries to fight off the virus. HIV symptoms which occur during this stage are similar to the other viral infections and may include:

• frequent fever and sweats
• tiredness
• yeast infections
• enlargement of the lymph node
• sore throat
• persistent skin rashes or skin flakes
• weight loss

In this stage, it is not possible to detect HIV through antibody tests.

Chronic HIV: In this stage, the virus is well established. You may not have any symptoms, but in a few patients, the swelling of the lymph nodes can continue. This can last for nearly 10 years or a little less and in the absence of treatment, your Immune System gets progressively weakened, and you may develop AIDs.

AIDS

If you are diagnosed with AIDS, it means that you have immunodeficiency. At this stage, you cannot fight the infections which your body could readily fight in the past. AIDS symptoms at this stage are mainly due to opportunistic infections and include:

• fever
• dry cough or shortness of breath
• difficulty or pain during swallowing
• severe headaches and neck stiffness
• nausea, vomiting, and abdominal cramps
• Diarrhoea lasting for more than a week
• white spots in and around the mouth
• pink to brown coloured blotches inside the mouth, nose, or eyelids
• vision loss
• seizures
• depression, memory loss, and confusion
• coma
• development of various Cancers

Causes

HIV is transmitted from one person to the other through sexual contact, blood transfusions, sharing needles, mother to child during pregnancy or childbirth or Breastfeeding.

HIV does not spread through physical contact, air, water or insect bites.

Risk factors

Although HIV can affect anyone, irrespective of age or gender, the risk is, however, high in people

• who have unprotected sex
• who have another sexually transmitted infection (this allows easy entry of the virus)
• who use intravenous drugs (due to the sharing of needles and syringes)

Complications

As HIV weakens your Immune System, you will have complications such as infections and Cancer.

Common Infections

Tuberculosis: This is the most common opportunistic infection and is the leading cause of death in AIDS patients.

Candidiasis: This is another common infection which occurs with AIDS, and thickens the mucus membrane of the tongue, mouth, esophagus and vagina.

Cytomegalovirus: This virus is dormant in healthy individuals. But in AIDS patients, it remains active and can damage the eyes, Digestive System, Lungs, etc.

Cryptococcal Meningitis: It is the infection of the central nervous system which leads to the inflammation of the membranes surrounding the Brain and the spinal cord.

Cryptosporidiosis: This infection is caused by an intestinal parasite, which causes severe and Chronic Diarrhoea in AIDS patients.

Common Cancers

Kaposi's Sarcoma: This is a Cancer of the walls of the blood vessels. This Cancer is common in HIV-infected patients but is otherwise rare.

Lymphomas: This is Cancer of the white blood cells and first appears in the lymph nodes.

Other HIV-related complications

Kidney Disease: In HIV-infected patients, the tiny filters of the Kidney become swollen. This leads to an increase in the filtration of fluids and waste materials.

Neurological complications: Dementia complex is the most common complication which leads to diminished mental functioning and behavioural changes. Other neurological disorders which can occur include confusion, depression, forgetfulness, anxiety and trouble walking.

Wasting Syndrome: It involves the loss of body weight by nearly 10% along with Diarrhoea, weakness, and fever. The incidence of this complication is reduced with aggressive treatment.

Diagnosis

Early diagnosis helps in the prevention of the spread of the virus to healthy individuals. During the diagnosis of HIV, the presence of antibodies, produced against the HIV are detected in the saliva and blood. But this is possible only after 12 weeks after the infection.

Home test approved by the FDA is also available. If you test negative, you need to retest after 3 months for confirmation. If the result is positive, then your doctor may perform certain tests to detect the stage of HIV based on which the treatment varies.

CD4 count: HIV can signal AIDS when your CD4 cells (immune cells) fall below 200 mm3.

Viral load: The target viral load (determinant of HIV activity) with the treatment is below 40-75 copies/mL.

Drug resistance: This test determines if the viral strain is resistant to which of the HIV medications.

Treatment of HIV

HIV or AIDS cannot be cured but can only be managed with a combination of anti-viral drugs. There are several drugs available for HIV treatment and are classified as below:

Nucleoside or Nucleotide Reverse Transcriptase Inhibitors (NRTIs): Examples are abacavir, lamivudine-zidovudine, and emtricitabine-tenofovir.

Non-nucleoside Reverse Transcriptase Inhibitors (NNRTIs): Examples are efavirenz, etravirine and nevirapine.

Protease Inhibitors (PIs): Examples are atazanavir, fosamprenavir, darunavir and indinavir.

Integrase Inhibitors: Examples are raltegravir (Isentress), elvitegravir (Vitekta) and dolutegravir.

Entry or Fusion Inhibitors: Examples are enfuvirtide and maraviroc.

Treatment should begin for every HIV-infected patient with antiviral agents. But immediate initiation is more important for people:

• with opportunistic infections
• who have severe symptoms
• whose CD4 count is below 350 mm3
• who are pregnant
• who are treated for hepatitis B or C
• who have associated Kidney Disease

Treatment involves taking multiple drugs at the scheduled time every day for your lifetime.

Self-management

Treatment with medications is not avoidable for patients with AIDS. However, taking certain measures can help you to stay healthy during the treatment.

Eat healthy: To support your Immune System and keep you strong and energetic, eat a diet including fruits, vegetables, lean proteins and whole grains. Avoid raw eggs, unpasteurized dairy products, etc.

Get immunized: To prevent infections such as Pneumonia and flu, get vaccinated (specifically with killed vaccines).

Be careful with pet animals: Some animals contain parasites lodged in their dander and can increase the risk of infections. Keep away from your pet animals or wash your hands thoroughly after handling them.

Coping and support

As AIDS is a life-threatening condition, the patient needs emotional, social and financial assistance to cope with the disease. There are several HIV clinics and resources which provide counselling and other services to support AIDS patients.

HPV causes STD

HPV is the short form of Human Papillomavirus which is one of the most common sexually transmitted viral diseases. Some strains of HPV are the causative agents for the common warts seen on hands and feet while others cause warts in the throat or genital areas. Few of the high-risk HPV strains are of particular concern as far as chances of progression to Cancer are concerned.

Your body may fight off HPV naturally, and then the infected cells can go back to being normal. However, if you are one of the few in whom the body does not fight off HPV, there are visible changes in the form of Genital Warts (single or multiple painless cauliflower-like growths) or Cancerous changes.

While warts appear within weeks or months of contracting the infection, Cancer often takes years to develop. In some rare cases, it can cause warts in the throat that is called RRP/Recurrent Respiratory Papillomatosis.

While low-risk HPV causes only Genital Warts, high-risk HPV can lead to Cancer of the cervix, vagina, vulva and anus in women and Cancer of the anus and penis in men. Certain strains of HPV can cause changes in the cells of the cervix which if left untreated can progress to Cervical Cancer.

Your risk of Cervical Cancer is increased if you smoke, have many children, start a sex life before age 18, and have multiple sex partners.

If you are a man infected with HPV, Genital Warts are seen to appear on your penis, on the scrotum, in or around the anus, or on the groin. Diagnosing the condition may be difficult unless there are external visible Genital Warts.

You do not need any treatment unless you develop symptoms and the infection also does not place you at a higher risk for Cancer as seen in women.

Symptoms

In most cases, the HPV is removed by the Immune System before the warts begin to appear. They vary in appearance depending on the variety of HPV. A few symptoms of the HPV virus are:

• Genital Warts
• Common warts
• Plantar warts
• Plat warts

Contracting HPV

HPV infection is primarily transmitted by sexual intimacy. Penetration is not required to transmit the virus from one person to another. Your risk of infection increases as your number of sexual partners increases.

You can get HPV if have skin-to-skin contact during vaginal, anal or oral sex with a partner who already has HPV even if he/she has no signs or symptoms of the disease.

If you are pregnant and have genital HPV virus then you may pass it on to your baby during vaginal delivery in which case your child can develop RRP. The presence of warts in the partner makes the condition more contagious.

Early screening: the best option

There are no blood tests for diagnosis of HPV.

The Pap test (sometimes called a Pap smear) is one of the tests you may have to undergo for detection of abnormal cells in the cervix that may lead to Cancer, infection, and inflammation.

You need to have a Pap test at least once every 3 years, beginning about 3 years after you begin to have sexual intercourse, but no later than age 21. If your test shows abnormal cells your physician may suggest further testing, such as colposcopy and Biopsy of any abnormal areas. (In colposcopy a lighted magnifying instrument called a colposcope is used to examine the vagina and cervix. Biopsy involves the removal of a small piece of tissue for diagnosis.)

Follow-up with the HPV test is recommended for Cervical Cancer screening if you are over 30 years of age and show an ambiguous Pap test report. The test can detect high-risk types of HPV even before there are any conclusive visible changes to the cervical cells. However, there are no currently approved tests to detect HPV infection in men.

Is there a cure?

If you test positive for HPV it does not mean that you will need treatment, at least not immediately. While close monitoring is advised, only a small number of women infected with HPV will develop cellular changes that need to be treated.

There is no medical cure for HPV infection. Your physician can help in the treatment of the lesions and warts caused by the infection. However do not try to treat the warts yourself, especially with the over-the-counter chemicals as they can irritate the skin.

Your physician can suggest a few treatments for HPV to remove the warts by methods that include cryosurgery (freezing that destroys tissue), LEEP (loop electrosurgical excision procedure, the removal of tissue using a hot wire loop), and conventional surgery. Your physician may also prescribe certain drugs available for the treatment of external Genital Warts.

Preventing HPV: Vaccines

• The only sure way to prevent HPV is to avoid sexual activity. While this may not be a practical solution, you can lower your chances of getting HPV by being in a relationship with one partner/ limiting the number of sex partners.
• The use of a condom can lower the risk of HPV-related diseases, but the virus is seen to infect areas that are not covered by a condom.
• Other ways to lower your chances of getting HPV are by vaccines available for men and women against the most common types of HPV. You must take all three doses of the vaccine for best protection. They are most effective if you take them before your first sexual contact.
• If you are a woman seeking protection against HPV which can cause Cervical Cancer you can choose from two vaccines; Cervarix and Gardasil. The latter one is also seen to protect against most Genital Warts. They are recommended for 11 or 12-year-old girls and for females between the ages of 13 and 26 years of age who have not been vaccinated earlier. The vaccine consists of a series of three shots, with shot two coming 2 months after the first, and shot three coming 6 months after the first.
• Gardasil vaccine is also recommended for boys and men between the ages of 9 and 26 years of age for protection against most Genital Warts. However, the efficacy of these vaccines in men and women older than 26 years of age is yet to be validated. If you already have HPV, the vaccine does not treat or cure it, but can still help protect against other types of HPV infections (other than those that cause Cervical Cancer; for example, the vaccine can help protect against the HPV that causes Genital Warts).

Causes

There are many causes for Hypercalcemia, some of them include:

Hyperparathyroidism: The most common cause of Hypercalcemia is Hyperparathyroidism, mainly in women above 50 years of age. When the parathyroid glands are hyperactive, they release more amounts of Parathyroid Hormone (PTH). Because of this too much calcium is regulated in the body leading to Hypercalcemia.

Cancers and Lung Disease: Certain diseases such as Tuberculosis can cause the levels of vitamin D to rise. As vitamin D absorbs more amounts of calcium, the calcium levels in the blood are raised. Cancer types such as Lung, Breast, and blood Cancers also raise the levels of calcium in your body.

Dietary supplements: Administering too much of vitamin D supplements and calcium may increase your blood calcium levels and make you develop Hypercalcemia.

Drugs: Certain drugs such as diuretics may increase the levels of calcium in the blood due to fluid excretion and calcium retention. Some drugs such as lithium may increase the release of PTH which can lead to Hypercalcemia.

Dehydration: In Dehydration, your body excretes the body fluids, and this causes a rise in the blood calcium levels resulting in Hypercalcemia.

Symptoms

In mild cases, there would not be any symptoms, but as the severity increases there would be a complex impact on vital organs of your body which includes:

Kidneys: When there is excess calcium in the blood, the workload on your Kidneys will increase. This causes excess thirst and frequent urination.

Digestive Tract: You may experience nausea, vomiting, and constipation.

Bones and muscles: You may feel bone pain and weakness

Brain: You may feel lethargic, fatigued, and finally confused due to Hypercalcemia.

When to call a doctor?

You must call your doctor when you experience symptoms such as extreme thirst, frequent urination, and abdominal pain.

Diagnosis

Your doctor would first order a blood test to understand the level of calcium in the serum. In the case of high calcium levels, your doctor would order some more tests to find out the cause. Your doctor would order a few tests to check for evidence of Cancer or other underlying causes of Hypercalcemia. Other tests may include:

MRI Scan – to produce detailed images of organs

Chest X-rays – to detect the presence of Lung Cancer

Mammograms – to diagnose the presence of Breast Cancer

CT Scan – to understand the detailed image of your body

Treatment

Hypercalcemia treatment includes:

• Bisphosphonates – inhibit bone reabsorption
• Denosumab – to treat Hypercalcemia of malignancy
• Loop diuretics – to treat extremely high calcium levels and prevent irregular Heart rhythms and damage to the Nervous system
• Peritoneal or hemodialysis – to treat Hypercalcemia associated with severe malignancy and renal insufficiency
• Isotonic sodium chloride solution – to treat extremely high calcium levels
• Surgical intervention - If the cause of Hypercalcemia is due to hyperparathyroidism, then your surgeon would locate the overactive gland and surgically correct it.

Lifestyle modifications

With small lifestyle modifications, you may prevent the risk of damage to vital organs that are affected by Hypercalcemia.

• Quit smoking as it may increase your risk of bone loss.
• Consume soy products, rice or almond milk instead of dairy products (high calcium foods).
• Drink plenty of fluids as they helps in avoiding Dehydration and preventing the formation of Kidney stones.
• Maintain your bone density by performing regular exercise after your calcium reaches normal levels.

Subtypes of HES

There are two subtypes of HES:

Myeloproliferative variant: this type of HES is associated with a small interstitial deletion in chromosome 4. The patient often has Anaemia, Thrombocytopenia, Splenomegaly, Myelofibrosis, and elevations in the serum vitamin B12 levels.

Lymphoproliferative variant: this type of HES is associated with a clonal population of T cells with aberrant phenotype. Patients with this subtype often experience skin abnormalities, angioedema, hypergammaglobulinemia, and serum sickness.

Causes

HES have no clear cause. It results from certain types of Cancer, such as Bone Marrow or Lymph Node Cancer. It is also caused by Parasitic and Fungal Infections, Toxins, Skin Disorders, Endocrine Disorders, etc.

Symptoms

HES is more common in adults. However, it can occur at any age. Some of the common symptoms of HES include:

• Fever
• Cough
• Fatigue
• Skin rash
• Dizziness
• Confusion
• Mouth sores

Diagnosis

Your doctor will diagnose the HES by ruling out the secondary causes and clonal eosinophilia. The doctor will take the medication history and perform a thorough examination. An Immunologist would effectively diagnose the problem and collaboratively work with specialists such as Haematologists or Cardiologists in treating and monitoring the HES.

The diagnostic testing is specific according to your symptoms which may include evaluating the stool for detecting the parasite, allergy testing, biopsies of skin or other organs, blood tests for screening autoimmunity or CT scanning of the affected organs.

If you are diagnosed with HES, your doctor would determine the extent of organ damage, for this, a chest X-ray and Echocardiogram (ECG) are performed to evaluate your Lungs and Heart. Your doctor will also perform certain tests to evaluate your Liver and Kidney functioning. Erythrocyte Sedimentation Rate is performed to find out the presence of infection in the body.

Treatment

The main goal of the treatment for HES is to reduce the tissue and blood eosinophils and to monitor and restrict organ damage.

Your doctor would prescribe corticosteroids as first-line drugs- e.g.: Prednisolone along with hydroxyurea. Interferon alpha is given as a second-line drug. If both these drugs fail to act then, your doctor will prescribe monoclonal antibodies such as mepolizumab and alemtuzumab which can be successful.

In the case of refractory HES, your doctor would recommend allogeneic hematopoietic cell transplantation. Other treatment measures would include anticoagulation therapy and agents that give symptomatic relief (opiates, histamines). The rest of the treatment will depend on the organs involved- e.g.: diuretics in cardiac failure.

Causes

Many factors can cause low levels of sodium in your blood including the following:

• Medications such as diuretics, antidepressants, and painkillers
• Heart problems such as Congestive Heart Failure
• Kidney Failure
• Liver diseases
• Syndrome of Inappropriate Anti-diuretic Hormone (SIADH)
• Chronic vomiting and Diarrhoea
• Dehydration
• Drinking too much of water
• Adrenal gland disorders such as Addison’s Disease
• Hypothyroidism
• Diabetes insipidus
• Cushing’s syndrome

Symptoms

If the levels of sodium deplete gradually, then you may not experience any signs and symptoms. But if there is an abrupt decrease in the sodium levels, you may have the following Hyponatremia symptoms:

• Nausea and vomiting
• Weakness
• Confusion and headache
• Muscle cramps
• Irritability

Sometimes, if the sodium levels drop rapidly, it may lead to potentially life-threatening diseases such as rapid Brain swelling, coma, and death.

Risk factors and complications

Factors that increase your risk of developing Hyponatremia include the following:

• Older adults are at increased risk due to age-related changes, taking medications, and history of certain diseases.
• Medications may also increase the risk of Hyponatremia.
• Medical conditions that prevent the excretion of water from your body may lead to Hyponatremia.
• Strenuous physical activities may increase your risk of low sodium levels.

Diagnosis

Occasionally, your doctor suspects Hyponatremia if you have neurological abnormalities. To confirm the diagnosis, your doctor might order blood tests and urine tests; and also clinically assess the volume status in your body. The normal range of sodium in your blood is 135 to 145 mEq/L.

Treatment

Hyponatremia treatment mostly depends on the underlying cause. If you’re diagnosed with moderate Hyponatremia that may be due to your diuretics, drinking high amounts of water or diet, then your doctor might recommend lowering the intake of water or adjusting the dose of diuretics.

The treatment for severe and sudden decrease of sodium levels in your body includes the following: Your doctor might prescribe intravenous sodium infusion to increase the sodium levels in your blood. To manage the symptoms of Hyponatremia such as headache and nausea, your doctor might recommend certain medications.

Prevention

You can prevent Hyponatremia by adopting a few measures that are listed below:

• Have a hydration plan such as supplementing water with electrolyte beverages
• Know your sweat rate so that you can determine the fluid consumption during exercise
• Increase the consumption of dietary sodium (as per the recommendation of your doctor).
• Record your weight before and after exercise to monitor your fluid consumption.

Causes and Risk Factors

Hypothermia mainly occurs due to the overwhelming cold environment which cannot be regulated by the body’s thermal defense system. The body generates less heat and loses more heat in such environments.

The other Hypothermia causes are:

• Not dressing appropriately for cold weather
• Not drying properly after getting wet in the rain

Risk factors for Hypothermia include:

• Young children and elderly patients, as they cannot regulate their body temperature efficiently
• Alcohol or drug addicts
• Certain mental illnesses such as Alzheimer's Disease
• Some medicines such as sedatives
• Some medical conditions such as Diabetes, Hypothyroidism, malnutrition, spinal cord injuries, burns and Parkinson’s Disease

Symptoms

The Hypothermia symptoms vary based on the degree of lowering of your body temperature.

Symptoms of mild Hypothermia (32-35˚C):

• constant shivering
• cold or pale skin
• low energy and tiredness
• hyperventilation (fast breathing)

Symptoms of moderate Hypothermia (28-32˚C):

• drowsiness
• slurred speech
• confusion
• loss of reasoning, thinking and judgment (removing clothes despite being very cold)
• difficulty moving around
• loss of coordination
• hypoventilation (slow, shallow breathing)

There is no shivering in such people indicating a deteriorated condition which needs immediate medical help.

Symptoms of severe Hypothermia (below 28˚C):

• dilated pupils
• a weak, irregular pulse, or no pulse
• coma that can result in death
• shallow or no breathing

A person who has severe Hypothermia appears to be dead, but immediate medical intervention can sometimes be helpful for such patients.

Babies with Hypothermia may look healthy, but have cold skin, are unusually quiet and refuse to feed.

Diagnosis

The diagnosis is based on the patient's history and physical examination. Some patients may show abnormalities with the ECG (Electrocardiogram) due to the development of Bradycardia (slow Heart rate). Blood tests may be performed to understand the severity of Hypothermia.

If an older person shows the symptoms of confusion, speech difficulty and lack of coordination, a rectal thermometer is used to measure the low temperatures.

Complications

Hypothermia can make the affected person more vulnerable to other cold-related conditions such as:

• Frostbite – Freezing of body tissues
• Gangrene – Decay and death of tissue due to an interrupted blood flow

Treatment and Self-management

If you find that someone is having Hypothermia symptoms, the first step you should take is to check for breathing and pulse and start cardiac resuscitation. Following this, rewarming should be done.

Before arriving at the hospital for treatment of Hypothermia, external rewarming can be performed. Warm packs of water bottles or chemical packs (around 41˚C) can be placed on the armpits, groin or abdomen of the patient. Palm and soul should not be rubbed to generate heat. This is because it can lead to stress in the Heart and the Lungs. You may provide warm, non-alcoholic beverages.

In severe cases, Hypothermia treatment should be started immediately to prevent Heart arrhythmias. Bretylium is used to treat arrhythmias in Hypothermia patients. The patient is kept in a warm environment. The wet clothing, if present is replaced with dry blankets or towels. After this, additional treatment with intravenous saline (heated at about 45 ˚C or 113 ˚F). Instilling warm fluid into the patient's bladder is also recommended in severe cases.

Less drastic methods are employed for patients with mild to moderate Hypothermia without other injuries or problems.

Symptoms

ITP may be symptom-free or may cause episodes of extreme bleeding that need emergency medical care. People with ITP may develop bruises on the skin even after trivial trauma.

Any cut in the skin may bleed longer and more. The bleeding can be spontaneous too. It manifests in the form of small pinpoint spots that may be red or purple and are more common on the lower legs. This type of rash is called purpura.

There can be localized bleeding in one site leading to a collection of blood. This is called a hematoma and feels like a lump. There can be spontaneous bleeding from the gums or nose.

Blood may appear in urine or stools and there may be heavy bleeding during the monthly menstrual cycles in females.

If such people undergo surgery, there may be excessive bleeding during the procedure. Patients may feel tired and weak due to bleeding. Medical help should be sought for any episode of bleeding, in particular for extreme bleeding.

Diagnosis

ITP is a diagnosis of exclusion, i.e. the doctor may rule out other possible causes of bleeding before making a diagnosis of ITP.

After a detailed talk about the symptoms and the patterns of bleeding, the doctor may request a blood test for a complete blood count and the bleeding and clotting times. This will reveal the low numbers of platelets and prolonged bleeding and clotting times.

In addition, a blood smear may be done. This enables a study of the shape and size of blood cells under the microscope.

A Bone Marrow Biopsy or aspiration is another test. This is done by inserting a needle through the skin into one of the superficial bones like the chest bone to take a sample of the marrow which is a soft tissue present in the bones where the platelets and blood cells are produced.

A Bone Marrow Examination in ITP typically reveals normal platelets as the cells are destroyed in the bloodstream after they are released from the marrow.

Treatment

Children have ITP that is different from that in adults. ITP in children may not warrant treatment as it may resolve by itself after a few weeks or months. Around 80% of children may recover within 6 months. Some may however have a prolonged illness. In them, it is treated as in adults.

Unlike children, very few adults with ITP have a spontaneous recovery. The goal of purpura treatment is to ensure a good platelet count and prevent bleeding.

• Consumption of medicines like aspirin that can inhibit platelet function or warfarin that can cause blood thinning should be discontinued.
• The most common medicines used for treating ITP are corticosteroids. These decrease the activity of the Immune System and check the destruction of platelets.
• Steroids should be begun and tapered in a stepwise manner. Once the platelet count is restored, these can be gradually withdrawn. These are usually required for two to six weeks and maybe started again in case of relapse.
• The injections of Intravenous immune globulin (IVIG) are used when platelet counts need to be restored within a short span like in the case of surgery.
• Another new class of drugs is the thrombopoietin receptor agonists like romiplostim and eltrombopag which help the bone marrow to produce more platelets and hence reduce bruising and bleeding.
• If these medical measures do not help, then a splenectomy may be performed, i.e. the spleen may be surgically removed. This helps by removing the main destruction of platelets.
• In an emergency of extreme bleeding, platelet concentrates may be transfused and steroids may be given by injections into the blood vessels.
• If none of these measures helps, medicines like rituximab, cyclophosphamide, or azathioprine are used to suppress the Immune System.
• Any infection affecting the person should be treated with infection-fighting medicines called antibiotics. The goal of treatment is to safely ensure a platelet count that with prevent bleeding.

ITP in pregnant women

ITP in pregnant women may be difficult to diagnose as a rise in Blood Pressure or other problems in pregnancy can lead to a fall in platelet count. Pregnancy in itself can lead to low counts when it is called Gestational Thrombocytopenia.

ITP in pregnancy is not believed to harm the baby but some babies may develop a transient fall in platelets after birth. This usually returns to normal in a few weeks to months. Pregnant women with ITP are at higher risk of bleeding during and after childbirth.

Not all pregnant women with ITP may need treatment. Mild cases need not be treated. Only the moderate and symptomatic cases of ITP need treatment in pregnancy. IVIG is the appropriate initial treatment.

Steroids and immunosuppressive medicines may be used only if the benefits outweigh the risks to the developing baby. Splenectomy if required should be best done only in the second trimester and only for the severe cases.

As delivery approaches, a sample of the baby’s blood may be collected from a vessel in the head of the baby through the abdomen of the mother to predict the risk of bleeding in the baby.

Self Help

ITP needs some lifestyle changes. It is good to prevent injuries and to not engage in vigorous physical activities or sports. Alcohol and blood-thinning medicines should be avoided and any infections should be treated. You can live and enjoy a normal life with proper awareness and a little precaution.

Symptoms

Signs and symptoms of infectious diseases depend on the causative organism and differ for each infection.

• Fever and chills
• Diarrhoea
• Fatigue
• Muscle aches
• Weight loss
• Coughing
• Skin rashes

Causes

Bacteria cause infectious diseases such as Tuberculosis, Pneumonia, and Meningitis. Viruses cause illnesses ranging from the common cold to dreadful HIV. Examples of fungal infections are athlete’s foot, candidiasis, etc. Parasitic infections can occur due to protozoa, helminths, or ectoparasites. Trichomoniasis and giardiasis are examples of parasitic infections.

After the invasion of the organism, the protective mechanisms of the body fight against the organism. The disease occurs when these mechanisms are compromised, and the damage to the body by the organism begins. The organisms damage the tissues of the host by releasing some chemical toxins. The type and effect produced by the toxins in the body vary depending on the organism.

Infectious diseases can be transmitted through direct or indirect contact. Direct contact can be from person to person, animal to person, and mother to fetus. Indirect contact can be through carriers or vectors and food contamination.

The routes of transmission can be through droplet, sexual, oral, fecal-oral, iatrogenic, vertical, or vector-borne.

Risk factors

Anyone of us can get infectious diseases. But the chances increase if your Immune System is weakened or compromised. This may be due to conditions such as HIV or Cancer and the use of medications such as steroids that suppress the Immune System. Elderly people are more likely to develop infections as they suffer from comorbidities.

Diagnosis

Your doctor gives a provisional diagnosis based on your symptoms. Body fluids are analyzed to reveal the presence and type of organism present. Samples for laboratory tests include blood, urine, stool, throat swab, and spinal fluid. Spinal fluid is obtained through lumbar puncture. Your doctor would recommend one or more of these tests based on your symptoms. A microbial culture test is performed with the sample obtained to detect the organism.

Imaging tests such as X-rays help to rule out conditions that have similar symptoms. In a few cases, your doctor may also recommend a Biopsy to confirm the diagnosis.

Treatment

Your doctor chooses an appropriate treatment based on the causative organism.

Antibiotics are prescribed if the infection is caused by bacteria. Few exceptions such as Tuberculosis, anti-tubercular drugs are given rather than antibiotics. These medications can be bacteriostatic or bactericidal. Your doctor may prescribe oral, topical, or intravenous antibiotics based on the type and severity of the infection.

Antivirals are given to treat some, but not all viral infections. Antivirals are prescribed to treat conditions such as HIV, herpes, Influenza, and hepatitis. Antifungals are given for fungal infections and anti-parasitics are given for parasitic infections.

Self-management

All infections don’t require treatment, as some of the conditions are self-limiting. So, drink plenty of fluids and have adequate rest when you are ill. Follow some measures to prevent new or recurrent infections.

• Wash hands thoroughly before preparing food, eating, and after using the toilet.
• If you are caring for an infected person, wear masks and apply antiseptic lotion before and after coming in contact with the person.
• Use antimicrobial substances such as antiseptics for use on the skin and disinfectants for use on non-living objects. Keep your kitchen and the eating area very clean.
• Get vaccinated as immunization can reduce the risk of infection.
• Practice safe sex by using contraceptives like condoms during sexual intercourse.
• Don’t share personal items such as toothbrushes or razors.
• Adopt methods such as pest control to prevent vector-borne transmission.
• If you are travelling to an area where an epidemic disease is present, consult your doctor and ask for measures to prevent the infection.
• Long-term use of antibiotics can also cause opportunistic infections. So, use antibiotics for a duration recommended by your doctor.

Difference between cold and flu

It may be difficult to distinguish between the common cold and flu as both affect the upper respiratory structures and cause similar symptoms. The onset and severity of symptoms in the two conditions are however different. Compared to the cold, flu has a sudden onset and the symptoms are more severe.

Causes

Influenza is an airborne disease and it is contagious. This flu travels in air droplets when a person infected with this virus coughs, sneezes or talks. It enters through the mouth, nose or eyes and affects the healthy individual.

A person with a weak Immune System is easily prone to the disease.

Symptoms

The symptoms of Influenza may vary according to the stage of the illness.

• High fever
• Exhaustion
• Chills
• Fatigue
• Frequent body aches
• Headaches
• Poor diet
• Difficult to feed small babies

No stuffy or running nose should be casually taken to just another episode of the common cold. Several bacteria can cause similar symptoms which may ultimately progress to affect and destroy the Lung tissues to cause Pneumonia.

Most colds and flu last a few days to a week to ultimately resolve without any specific treatment. This is not of much concern and can be managed at home. However, one should be watchful for any signs of worsening disease.

If the child develops uneasy, noisy, or laboured breathing, very high fever, or distressing cough, one should seek medical help.

Caring for your child

• The child can be made to feel better by comforting care. The child should be allowed plenty of rest.
• It is good to not send the child to school or daycare.
• Small babies should be held upright to allow them easy breathing while at rest or sleep. The babies should be given Breast feeds and the elder children may be offered frequent sips of water or their favorite juice or popsicles.
• The child should be given a healthy and balanced diet.
• A comfortable temperature should be maintained in the child’s room and the humidity levels should be controlled to avoid too dry air.
• Humidifiers or mist may be used to moisten the air; this may relieve the symptoms of congestion and stuffiness and make breathing easier.
• The child may be given a relaxing warm water bath or maybe sponged with a warm towel.
• Saline nasal drops may be instilled into each nostril to clear away the blockade.
• The child may be encouraged to blow out the nose into a clean handkerchief.
• A suction bulb may be used to clear the nose in very small babies. The nozzle should not be pushed too deep inside.

Medications

• Syrups containing medicines like paracetamol or ibuprofen are available over the counter. These may be given to a sick child who develops fever or distressing body aches. These medicines may be used strictly according to the dosing instructions.
• Some are dosed according to the weight of the children. In that case, it is better to know the weight of the child. These are best used in children above 2 years. Babies less than 2 years of age should be given any medicine only after consultation with a doctor.
• Other medicines that may be prescribed for cold and flu include those like diphenhydramine, and chlorphenamine which are antihistaminics that oppose the action of histamine, a chemical signal that causes runny nose and itching in the throat and ears.
• If dry cough is a problem, cough suppressants may be used to provide relief. Expectorants are medicines that make the secretions less viscous and allow the child to cough them out easily.
• Nasal decongestant medicines like pseudoephedrine and phenylephrine help to relieve a blocked nose.
• Aspirin is one medicine that should be avoided in children. This can cause Reye’s syndrome, a life-threatening disorder that affects the Brain, Liver, and other organs.

Visiting the doctor

Most cases of common cold and flu resolve after a few days with proper care at home. However, it may be important to see the doctor if the child develops a high fever, the cough lasts many days and is accompanied by sputum which is coloured green or yellow, develops difficult and laboured breathing, the nasal discharge becomes yellow or green, the child complains of pain in ears or nose, the throat is intensely inflamed and pitch of the voice changes, chest wall shows retractions with breathing movements, and the child refuses to feed persistently, and the urine becomes dark and scanty.

Preventing cold and flu

• Common colds and flu are contagious and spread from one person to another. The child should be isolated from any person who has an illness. Frequently, children catch an infection in the daycare or nursery.
• A sick child should be allowed to rest at home. Frequent and proper hand washing should be encouraged. Hands should be washed before and after meals and after every use of the toilet. Hands should be washed with soap and lukewarm after and should be thoroughly scrubbed on both surfaces, between fingers and along nails for about 20 seconds before being rinsed.
• The tissues used to wipe the child’s face and nose should never be reused. These should be carefully disposed of in the dustbin and other children should not be allowed to access them.
• Hands should be washed after every diaper change.
• Anybody who has a cold should cough or sneeze by covering the nose and mouth with a clean handkerchief to avoid spreading it to children and others at home.
• The house should be kept clean and well-ventilated.
• Seasonal vaccination is recommended every year for the most prevalent strain of virus causing the illness.
• Anybody 6 months and older should get the vaccine.
• People caring for babies less than 6 months of age should be vaccinated. The 2010-2011 flu vaccine protects against an Influenza A H3N2 strain.
• Healthcare workers and children who are at high risk either due to an underlying medical condition or because they are too frequently exposed to an infection need vaccination.

Types of Lactation Mastitis

The absence of signs of infection makes it clear that the condition is caused due to milk stasis. Milk stasis is nothing but the buildup of milk within the Breast tissue in your lactating period.

Lactation Mastitis with infection is the common form and is presented as a breakage in the nipple or skin near the Breast. This is usually caused by staphylococcus bacteria.

Causes

The main causes of Lactation Mastitis are bacterial infection or milk stasis. Bacteria if present on the skin is harmless but when it tries to enter the Breast tissue it will cause infection and breakage of the nipple or the Breast skin.

Milk stasis makes the milk build up in the milk ducts this may cause inflammation and may lead to infection later.

Risk factors

The following factors can increase your risk of developing Lactation Mastitis:

• History of mastitis
• Wearing a tight bra
• Cracks in the nipples
• Breastfeeding for the first few weeks
• Always using the same position while Breastfeeding

The above factors may make you susceptible to infections of Breast tissue or may increase the risk of milk buildup in one or both Breasts.

Symptoms

You may observe that your Breasts are enlarged or swelled; there can be a feeling of tenderness or sensation of warmth near the affected area. You may feel itching. Your body temperature would increase and may find a small cut near your nipple.

Diagnosis

Your doctor performs a medical history review to identify the signs and symptoms. Later he would perform a physical examination which would reveal signs such as the wedge-shaped area near the Breast that is tender to touch and protrudes down to the nipple.

Your doctor would rule out if there is any presence of Abscess formation because it could be a complication of Lactation Mastitis.

Your doctor may collect the sample of milk and send it for a culture test; this helps your doctor to prescribe the best antibiotic if the type of mastitis is associated with infection.

If the signs and symptoms persist even after antibiotic treatment, your doctor would recommend a Mammogram to check for the presence of Cancer.

Treatment

• Antibiotics are usually prescribed. You must take them for two weeks to avoid recurrence.
• Pain-relieving medications such as acetaminophen or ibuprofen are also prescribed.
• Your doctor would ask a lactation consultant to monitor the way you Breastfeed the baby to ensure that the correct technique is being followed.
• You will be asked to rest well and continue to Breastfeed the baby; it is good for you to take more fluids to fight up the infections.

Causes

Acute Laryngitis is temporary and is caused by overuse or due to any underlying infection. Chronic Laryngitis can be caused due to long-term exposure to harmful chemicals.

The major causes of acute Laryngitis are viral infections, the strain on vocal cords, or may be due to bacterial infections.

The major causes of chronic Laryngitis are acid refluxes, overusing of voice, infections such as sinusitis, smoking and frequent exposure to harmful allergens.

Symptoms

The common symptoms of Laryngitis may include dry cough, loss of voice, throat irritation, weakened voice, and hoarseness in voice.

Croup is a symptom that occurs in infants and small children who are attacked with a bacterial form of Laryngitis. Croup is an inflammation of the throat which may develop into epiglottitis. Epiglottitis can become fatal if left untreated.

When to call the doctor?

You must call your doctor immediately if there is:

• Hypersalivation
• Trouble swallowing
• Difficulty in breathing
• Fever over 103 degrees Fahrenheit

Complications

In most severe cases of Laryngitis, which is caused by infection, the infection may spread to other parts of the respiratory tract and cause severe respiratory tract infections.

Diagnosis

Hoarseness of voice is the most common sign of Laryngitis. This can vary on the degree of infection. Your doctor may examine your vocal cords. Later he/she would order diagnostic tests such as:

Laryngoscopy: this technique helps your doctor to visually examine your vocal cords, for this a light and a tiny mirror are required. Your doctor may rather use a fibre-optic Laryngoscopy by inserting a flexible tube which has a tiny camera; this helps your doctor visualize the motion of your vocal cords.

Biopsy: if your doctor finds anything suspicious your doctor may take a sample of the tissue for Biopsy.

Treatment

Acute Laryngitis is self-limiting and gets better within a week or two. Following certain self-care measures would also speed the recovery and improve symptoms.

The goal of treatment for chronic Laryngitis is to treat the underlying causes, such as Heartburn, smoking or alcohol addiction.

Your doctor prescribes certain medications which include:

Antibiotics cannot work well because the major cause would be viral. If there is any evidence of bacterial infection, then your doctor will recommend the most suitable antibiotics for you.

Corticosteroids help reduce the inflammation in your vocal cords. But these drugs are reserved only for urgent needs in treating Laryngitis mainly in cases that have symptoms such as croup.

Lifestyle changes

Some home treatments and self-care remedies would help in alleviating the symptoms of Laryngitis:

• Breathing in moist air and inhaling steam would help clear the airway.
• Resting the voice as much as possible, by talking less and avoiding overuse of the voice
• Drinking plenty of fluids to prevent Dehydration
• Sucking on lozenges or gargling with warm salt water, or chewing on a gum
• Avoiding overuse of decongestants which dries your throat

Prevention

To prevent the irritation in your throat, you can follow the measures given below:

• Avoid smoking
• Limit alcohol consumption
• Avoid eating spicy foods
• Drink lots of fluids
• Eat more fruits and vegetables

About Latex Allergy

It is very surprising that despite being one of the most commonly used items in our daily life latex causes allergic reactions in many people. Until a decade ago, Latex Allergy was described as an unknown condition in medical text.

Latex, the natural rubber, consists of a protein that causes allergic reactions in people. Allergy triggers when one’s own Immune System acts against the latex protein. An allergic reaction can be as mild as a simple sneeze or it can be as severe as an Anaphylactic Shock (severe life-threatening allergic reaction involving the whole body).

The latex products that are rich in latex protein are gloves, balloons and condoms, which are usually thin and stretchy. The thick, hard latex products do not cause many allergies.

The latex allergic reaction is initiated when we inhale the air containing these latex particles. Thin latex products are coated with cornstarch powder that attaches itself to the latex protein.

When the gloves or condoms are used or removed frequently, these particles fly into the surrounding air and when inhaled cause allergic reactions.

Symptoms

The onset of allergic reactions usually takes 20-30 minutes. A person who is allergic to latex and its products might experience the following Latex Allergy symptoms. They are:

• Sneezing
• Runny nose
• Coughing
• Shortness of breath
• Chest tightness
• Eyes may turn red, watery, and itchy
• Rashes or hives may develop on the skin
• Abdominal cramps
• Diarrhoea

In sensitive people, wearing latex gloves may cause;

• Rashes
• Bumps
• Sores
• Red cracks in the hands

Symptoms of a life-threatening allergic reaction called anaphylactic shock include;

• Dizziness
• Wheezing
• Confusion
• Difficulty breathing
• Vomiting
• Nausea
• Fast or weak pulse
• Loss of conscious

These life-threatening conditions need immediate medical attention.

Risk factors

Latex Allergy is a very common problem that is increasing at a rapid pace. There are about 17 million Americans who are sensitive to latex. This increasing sensitivity is attributed to the extensive use and prolonged exposure to latex and latex products. A place sans latex products is difficult to find. Anyone can develop Latex Allergy. However, some groups of people who are placed under the high-risk category are

• People working in the rubber industry
• People working in healthcare centres
• Risk increases if the person has hay fever
• People born with Spina Bifida (a defect in spine development)
• People who have undergone many operations from a young age
• People with food allergies
• People with asthma
• People with a history of non-medication-related anaphylactic reactions during anaesthesia.

Latex Allergy and food

People who are allergic to latex are found to be allergic to some food items and vice versa. These foods contain a protein similar to the one that is present in latex products and causes allergic reactions.

The most common foods that cause allergic reactions are bananas, avocados, passion fruit, kiwi fruit, and chestnuts.

Many other foods may cause allergy but avoiding all of them may lead to improper nutrition. Therefore, it is sensible only to avoid those foods, which has already triggered an allergic reaction.

Diagnosing Latex Allergy

Latex Allergy is suspected, if someone develops some kind of allergic reaction shortly after being exposed to latex. If at all, any Latex Allergy reaction is faced, then do not delay in fixing an appointment with a physician, preferably one who is experienced in treating people with Latex Allergy.

Doctors may examine the symptoms in detail, which in most cases is sufficient for identifying Latex Allergy.

In a few, doctors may perform laboratory tests like patch tests. This is done to see the allergic reaction when the substance is contacted. This should be done only by very well-experienced and trained physicians as it might result in serious allergic reactions.

Skin tests may be done where the skin is rubbed or pricked by an object containing a drop of liquid latex protein, a positive reaction confirms Latex Allergy. This should be done only under the guidance of a well-experienced physician.

In addition, blood tests and Latex Allergy tests are done to detect the presence of latex antibodies.

Treatment

The best treatment for Latex Allergy is to prevent contact with latex and its products. Start with listing down the latex products that are used every day at home or the workplace, find a substitute for these products and make sure that all the latex products are replaced by their substitutes.

Non-latex rubber gloves should be used if working in a health care centre. The person should make sure that people working around him are using powder-free latex gloves or non-latex gloves so that he/she doesn’t inhale latex particles.

An allergic person can wear a medical bracelet or necklace showing that he/she is allergic to latex, in case of a medical emergency.

The person can consult the physician about using histamine in case of mild allergic reaction and epinephrine or adrenalin self-injection pen in case of severe allergic reaction. The dosage of epinephrine depends on the severity of symptoms.

Once hospitalized other supportive treatment procedures will be decided by the doctor. This would bring allergy relief for the person suffering from the allergic condition.

Clinical features

The infection primarily affects the skin, mucous membranes (nose), peripheral nerves (nerves outside the Brain and spinal cord), eyes and testes (in males).

Leprosy is classified as per the type and number of skin areas affected. Types of Leprosy based on severity include:

• Indeterminate Leprosy (IL)
• Tuberculoid Leprosy (TT)
• Borderline Tuberculoid Leprosy (BT)
• Borderline Borderline Leprosy (BB)
• Lepromatous Leprosy (LL)
• Borderline Lepromatous Leprosy (BL)

These forms of Leprosy manifested depend on the Immune System's response to the infection.

IL is the mildest form and can be cured or progress to the next stage.

LL is a severe and debilitating form that never reverts to a milder stage. c

TT is a milder form and is seen in patients with good immunity.

In between, are BT, BB and BL forms that can result again depending on the cellular immunity of the patient.

As per the number of skin areas affected, Leprosy is called paucibacillary, when five or fewer skin areas are affected. Skin samples from paucibacillary patients should not have any detectable bacteria.

When six or more areas are affected, it is known as multibacillary Leprosy, where most of the samples will show the presence of bacterial organisms.

Risk factors

The mode of transmission of Leprosy is still uncertain but is understood to spread from person to person via respiratory droplets when infected people cough or sneeze. The disease is not contagious, but certain factors that increase the risk of contracting the disease include:

• Close and long-term contact with the infected person
• Compromised Immune System (HIV/AIDS)
• Countries endemic to the disease

The disease is seen more often in the age group of 5 to 15 years or over 30 years, and rarely seen in infants. Countries with warm and wet climates; tropics and subtropics have more cases.

Worldwide prevalence is around 5.5 million, with 80 per cent of the cases from India, Indonesia, Myanmar, Brazil and Nigeria. Almost all the cases seen in the United States are a result of immigrants from developing countries.

Symptoms

The bacteria causing Leprosy disease multiply very slowly, as a result, the symptoms are not seen until a year after infection. Due to the slow progress of the disease, it can take an average of 5 to 7 years for signs to appear.

Paubacillary type is milder showing one or more hypopigmented skin macules (flat discolored lesions) and similar symptoms are seen in TT Leprosy.

Multibacillary type shows symmetric skin lesions, nodules, plaques (broad raised areas), thickened dermis and nasal congestion and bleeding, all of which are seen in severe LL type of the disease.

To some extent, all forms of Leprosy will show peripheral neurological damage, causing loss of sensation in the skin and muscle weakness.

In the long term, deformities (inward curving of the fingers, dropping of the foot) and disfiguring on the face can result.

Eyes may be affected by glaucoma or blindness, men may develop infertility and Kidneys may malfunction.

Diagnosis

Diagnosis of the disease is still based on the clinical signs and symptoms like localized skin lesions, sensory loss and Peripheral Nerve Damage.

A Skin Biopsy to observe the bacteria microscopically may be done to confirm diagnosis. The earlier the diagnosis, the better the chances for a cure.

Treatment

A list of Leprosy treatments are mentioned below:

• Antibiotics are used to treat Leprosy, and the World Health Organization (WHO) has recommended multidrug therapy (MDT) with dapsone, rifampicin and clofazimine regimen.
• In multibacillary cases, MDT every month for one year is given, while in paucibacillary cases, rifampicin every month and dapsone daily for six months is the treatment choice.
• People with only a single affected skin area are given a single dose of rifampin, ofloxacin and minocycline.
• The antibiotics can kill the bacteria, but cannot reverse the nerve damage or deformities caused by Leprosy.
• Dapsone being relatively inexpensive and safe to use, is recommended for lifelong treatment in lepromatous Leprosy.
• Patient education is also important, with an emphasis on taking the full course of medication. Dealing with nerve damage and how to protect numb limbs from injury should be taught.

Prevention

Overall, the risk of spread is low, and people on long-term medication become non-infectious. Only untreated lepromatous Leprosy can be contagious. Preventive measures include avoiding contact with body fluids and rashes of infected people.

A leper is a human

The WHO has made MDT freely available to most of the endemic countries, to reach the elimination of the disease (less than 1 case/10,000 people).

Pockets of high endemicity remain (Angola, Brazil, Central African Republic, Tanzania, republic of Congo, India, Madagascar, Mozambique and Nepal) and in such areas, information campaigns to educate patients who are ostracized from their communities, to come forward and receive treatment is very crucial.

Many people affected by the disease get rejected by society and it becomes the duty of the scientific and educated sections of society to rehabilitate them and give them as normal a life as possible.

Two major rehabilitation forms are physical and socio-economic. Physical rehabilitation programs provide physiotherapy, and occupational therapy, and aim to help meet the physical demands of daily life.

Socio-economic rehabilitation helps affected people rebuild their lives, reassuring families and communities about facts on Leprosy, and helping them live a fulfilling life filled with dignity.

Causes

The exact cause of Leukoplakia is unknown. But, the primary reason can be tobacco use. Consuming tobacco in any form can affect the tongue and mouth. Three out of every four smokers would develop Leukoplakia at some point during their lifetime.

There may be other causes for Leukoplakia which include:

• Cheek biting
• Uneven, rough teeth
• Drinking more amounts of alcohol
• Dentures which are fitted improperly

Hairy Leukoplakia

The main cause of hairy Leukoplakia is Epstein-Barr virus (EBV). If once it enters your body it remains there for a lifetime. EBV is dormant, but the hairy Leukoplakia patches can be developed at any time. The outbreaks mainly occur in people with compromised Immune Systems, such as HIV patients or other patients with other Immune System problems.

Symptoms

Leukoplakia patches usually develop on the tongue and insides of the cheeks, and sides of the tongue may develop hairy Leukoplakia.

The patches are:

• Looks fuzzy
• Uneven in shape
• Difficult to scrap off
• White or greyish in appearance
• Slightly elevated with a hard surface
• Painful when coming in contact with spicy foods

Diagnosis

Your doctor would perform an oral examination. You may mistake Leukoplakia with oral thrush which is a yeast infection. Patches in oral thrush are softer than Leukoplakia patches, and they bleed, which does not occur in Leukoplakia.

Your doctor performs a physical examination, to confirm the patches as Leukoplakia. Your doctor would order further tests to confirm the cause of appropriate Leukoplakia treatment may help prevent future patches from developing or worsening the present patches.

Your doctor would order a Biopsy if the patch looks suspicious. For this, a small tissue is removed and sent to a pathologist for diagnosis. This test helps to rule out the possibility of Oral Cancer.

Treatment

The goal of the treatment is to get rid of the Leukoplakia patches, however, mild forms of Leukoplakia cure on their own, but severe cases require the removal of the cause which makes the patch disappear automatically.

Treating the dental causes such as irregular, rough teeth, rough denture surfaces, crowns or fillings as soon as possible, as these may be a cause for Leukoplakia patches

• Your doctor will advise you to quit smoking and avoid tobacco-related products.
• Your doctor will ask you to quit alcohol.

If treating the source of the infection does not cure the patch, then your doctor would prescribe topical medications or surgically remove it.

In the case of oral hairy Leukoplakia, your doctor would prescribe antiviral medications that cure the patches. Your doctor would also prescribe topical gels to treat the patch.

Prevention

Simple changes in the lifestyle may show great impacts in the cure of Leukoplakia.

• You must reduce alcohol consumption
• You must stop smoking or chewing tobacco
• You must eat an anti-oxidant-rich diet, such as spinach, and carrots. Anti-oxidants help in fighting the irritants that cause patches.

Causes

Listeria monocytogenes is a gram-positive bacteria found in soil, water, and animal faeces. You may be affected if you consume contaminated raw vegetables, infected animal meat, unpasteurized milk, and cooked or processed foods such as hot dogs, soft cheeses, and deli meats.

Unlike most other bacteria, Listeria monocytogenes can survive refrigeration and grow rapidly. Unborn babies can be infected if the mother consumes food contaminated by the bacteria.

Sources of Listeria monocytogenes

• Ready-to-eat deli meats and hot dogs
• Refrigerated foods or meat spreads
• Unpasteurized (raw) milk
• Soft cheese made with unpasteurized milk
• Refrigerated smoked seafood
• Raw sprouts

Symptoms

Healthy people when exposed to the bacteria may develop mild or no symptoms. The symptoms of Listeria Infection include the following:

• Nausea
• Diarrhoea
• High body temperature
• Headache
• Muscle aches
• Stiff neck
• Confusion
• Loss of balance
• Convulsions

Pregnant women may experience fever and other symptoms such as fatigue, and muscle aches. However, if pregnant women are infected with Listeria monocytogenes, it can lead to miscarriage, premature delivery, or life-threatening complications in the newborn.

These symptoms may begin a few days after consumption of the contaminated food. However, the duration of onset of symptoms is about three to 70 days.

Risk factors

The risk of Listeria Infection is high in pregnant women, newborns, older adults, and individuals who have a weakened Immune System.

The conditions that cause the Immune System to be compromised are AIDS, Diabetes, Kidney Disease, taking corticosteroids and other immunosuppressive drugs. Although Listeria Infection causes mild symptoms in pregnant women, it may cause life-threatening complications for the fetus or the newborn.

Complications

If the infection is left untreated, it may lead to following complications.

• Blood infection (septicemia)
• Inflammation of the layers of your Brain (Meningitis)
• In pregnant women, it may lead to stillbirth, miscarriage, or premature birth

Diagnosis

The most effective way to determine the Listeria Infection is to undergo blood tests. Your doctor may suggest a blood test where a sample of your blood is tested for the strains of bacteria. Sometimes, urine analysis and spinal fluid analysis may be recommended. According to the Centers for Disease Control and Prevention (CDC), there are no reliable serological tests available currently to identify the infection.

Treatment

In a majority of the cases, the infection clears off without any medical care. But, in people who are at high risk, immediate treatment is required to avoid life-threatening complications.

Listeria Infection can be treated with antibiotics. Intravenous ampicillin is considered as first-line treatment for Listeria Infection. Also, some research studies demonstrated the effective use of trimethoprim-sulfamethoxazole therapy.

Antibiotics for treating Listeria Infection in pregnant women prevent the spread of the infection to the baby. A combination of antibiotics is recommended for newborns who are infected with Listeria bacteria.

Prevention

The risk of Listeria Infection can be reduced by adopting the following measures.

• Cook raw food from animal sources thoroughly
• Rinse or scrub the raw vegetables
• Maintain cleanliness while preparing the food
• Store the foods safely
• Avoid drinking unpasteurized milk or foods prepared from unpasteurized milk
• Avoid consumption of refrigerated smoked seafood

Causes

When bacteria, viruses, or fungi attack the lymph nodes, they get enlarged or swollen up due to inflammation. These are usually found near the site of an infection, Tumour or Inflammation. Certain skin infections caused due to streptococcus or staphylococcus may increase your risk of developing Lymphadenitis. Infections such as Tuberculosis and Bartonella also may cause Lymphadenitis.

Symptoms

The most common symptoms that you would experience during Lymphadenitis are:

• Red skin (which is tender to touch) over the lymph nodes
• Swollen and hardened lymph nodes

You may feel that the lymph nodes are rubbery to touch in case they are filled with pus or have become inflamed.

Complications

The common complications that may occur due to Lymphadenitis are:

• Sepsis (a potentially life-threatening condition)
• Fistulas (abnormal connections between two body parts)
• Cellulitis (skin infection which involves redness and swelling)
• Abscess formation (collection of pus within the tissues)

Diagnosis

The doctor will perform a physical examination. This lets him, or her understand the extent of swelling or sensitivity of your lymph nodes. Your doctor would order blood tests to check for infections, X-rays and CT scans to check for the presence of Tumours or to find the source of infection.

To rule out other possible conditions, your doctor would order a Lymph Node Biopsy. This is a short procedure which involves the removal of a sample of tissue from the lymph node. The sample is then tested for the cause.

Treatment

Immediate treatment is required for Lymphadenitis because it spreads within no time. The treatment options may include:

Antibiotics: If the cause of lymph node swelling is an infection, then your doctor would prescribe an ideal dose of antibiotics to fight the infection-causing bacteria.

Analgesics (pain killers): Your doctor prescribes painkillers such as ibuprofen. This helps in reducing the pain as well as the temperature of the body. You must also use a cold compression and elevate the swollen area to reduce the swelling.

Abscess draining: If you notice any Abscess filled with pus, then your doctor will drain it by making a small sterile cut. Later the area is packed with gauze for healing.

Cancer management: If there is evidence of Cancer of the lymph node, your doctor would recommend surgery which involves removal of the Tumour in the lymph node. Chemotherapy or Radiation Therapy is also suggested.

Causes

The major causes of Lymphedema are:

• Cancer
• Infection
• Removal of lymph nodes
• Scar tissue left as a result of Radiation Therapy
• Inherited conditions such as absence or abnormal lymph nodes

Symptoms

The common signs and symptoms of Lymphedema include thickened skin, recurring infections, feeling of tightness, reduced range of motion, swelling in the arms or legs, discomfort or severe aching.

The swelling in the Lymphedema may be mild, but if it is severe, the size of the arm makes it difficult for you to use it.

You must call the doctor immediately if you notice any persistent swelling in your arms or legs or both.

Risk factors

Factors that may increase your risk of developing Lymphedema are old age, overweight, and Rheumatoid Arthritis.

Complications

Lymphedema can lead to severe complications such as:

There may be a chance of infections such as cellulitis or lymphangitis. The tiny or smallest injury to the affected area may be the entry point for an infection.

Lymphangiosarcoma is a rare soft tissue Cancer that may be a result of a severe form of Lymphedema or may be due to untreated Lymphedema. The possible signs of Lymphangiosarcoma include blue-red or purple marks on the skin.

Diagnosis

Your doctor performs a physical examination and conducts a medical history review. If the cause of the condition is not clear, then your doctor may order other imaging tests to look at your Lymphatic System, imaging tests include:

• MRI Scan: is used to view the lymph system in a better dimensional way
• CT Scan: helps in revealing the blockage in your Lymphatic System.
• Doppler Ultrasound: it helps in looking at the blood flow and pressure of the sound waves off the red blood cells. Ultrasound helps in finding the obstructions.
• Radionuclide Imaging: involves the injection of dye and then scanning with the help of a machine. The images produced would highlight the areas of blockage.

Treatment

There is no cure for Lymphedema. The primary goals of the treatment focus on reducing the swelling and controlling the pain. The treatment options for Lymphedema include:

Physical activity: moving your affected limb slightly helps drain the lymph fluid and makes it easy for you to perform the day-to-day operations.

Wrap your arm: The application of a tight bandage on the entire limb encourages lymph fluid to flow back towards the trunk.

Massage: performing special massage techniques manually to drain the lymph fluid from the arm or leg. Avoid massage if you have an infection, blood clots or Congestive Heart Failure. Also, avoid massage on the areas exposed to Radiation Therapy.

Prevention

Follow the tips given below to prevent Lymphedema:

• Avoid compressing or tight clothing
• Always keep your arms or legs clean
• Protect your arms or legs from injuries
• Rest your arms or legs while recovering
• Elevate your arm or leg to reduce the swelling
• Avoid application of ice or heat on the affected area

Signs and symptoms

After the infected mosquito (female Anopheles) bites us and releases the parasite into the bloodstream, it takes between seven and 30 days (an average of 15 days) for the symptoms to develop. This period is known as the incubation period. In some people, symptoms may not develop for several months after infection as these parasites will be dormant.

Symptoms of Malaria can be divided into uncomplicated or complicated (severe).

The most common symptoms of uncomplicated Malaria are

• Fever and chills
• Headaches
• Nausea and vomiting
• General weakness and body aches

The most common symptoms (when different body systems are affected by Malaria) of complicated or severe Malaria are:

• Severe Anaemia (due to destruction of RBCs)
• Kidney Failure
• Cerebral Malaria (characterized by seizures, unconsciousness, abnormal behaviour, confusion)
• Cardiovascular collapse
• Low blood sugar (after treatment with quinine in pregnant women)

Causes

The primary and major cause of Malaria is the transmission of the parasite into the bloodstream through the infected female Anopheles mosquito. Malaria is congenital; which means an infected mother can also pass the disease to the baby at birth. This disease is also transmitted by blood, so it can also be transmitted through an organ transplant, a transfusion, and the use of shared needles or syringes.

Risk Factors

The biggest risk factor is visiting the place where Malaria is endemic.

People who are at risk of serious disease include:

• Children and infants
• Travelers from areas where Malaria is uncommon
• Pregnant women and unborn children

Complications

Malaria can be lethal. In most cases, deaths due to Malaria are related to one or more serious complications, which include:

• Cerebral Malaria is caused when the parasite-filled blood cells block small blood vessels in the Brain, causing swelling and damage to the Brain. Cerebral Malaria may cause coma.
• Breathing problem is due to accumulated fluid in the Lungs known as pulmonary Edema due to Malaria.
• Organ failure mainly Kidneys Liver or spleen failure due to Malaria and these conditions can be life-threatening.
• Anaemia is due to the destruction of red blood cells by the parasites.
• Low blood sugar is due to severe forms of Malaria itself and the drugs used for Malaria treatment such as quinine. Very low blood sugar may lead to coma or death.

Diagnosis

Malaria is diagnosed with the help of different types of blood tests which can show the presence of the parasite.

Your doctor may recommend you take the blood smear test mainly to determine

• if you have Malaria
• the type of Malaria parasite causing symptoms
• if the infection-causing parasite is resistant to certain drugs
• whether the disease is affecting any of your vital organs

Some blood tests take several days to complete, while others can produce results in less than 15 minutes. One such is a rapid diagnostic test also known as antigen test which can give the diagnosis in a few minutes. It is recommended that a positive test be followed with a blood smear examination.

Treatment

Your doctor will prescribe medications based on the type of parasite responsible for your infection. Medications may not always clear you from infections as few parasites are resistant to drugs. If this condition occurs, your doctor uses more than one drug or changes medications altogether to treat you.

The medications or antibiotics prescribed depend on the specific species of parasite identified, the severity of symptoms, and the determination of drug resistance species. Medications can be given in the pill form or the intravenous form depending on the above factors.

Prevention or self-management

There is no vaccine for Malaria, and no medication is 100% effective. Therefore the prevention of mosquito bites is of great importance. Prevent mosquito bites by sleeping under bed nets; use clothing that covers most of the exposed skin to reduce the risk of bites. Also, treating clothes and bed nets with insecticides can prevent bites even further.

In case you are travelling to places where Malaria is common, talk to your doctor and take preventive medication before, during, and after your trip.

Risk factors

The elderly with weak defence systems in the body who remain hospitalized for a long duration for any medical illness are at risk for hospital-acquired (HA)-MRSA. However, a person of any age can be affected.

The risk increases when there are any medical devices used for medical management in the hospital. These include the cannulae and catheters that are inserted into the body through the skin, nose, or urinary outlet.

A person who is a carrier of MRSA may transmit the MRSA infection without having symptoms of the infection. A special risk is through the hands of nurses and healthcare personnel who examine several patients without washing hands after each one is touched.

Community-acquired (CA)-MRSA affects the healthy general population and spreads through direct or skin contact. People at highest risk are those who live in crowded conditions, childcare workers, workers in old age homes, wrestlers, military training camps, jails, and daycare centres. Homosexuals have a greater risk for MRSA.

Such infections are usually localized and cause a pimple, boil, pustule, or an infected wound. The infection spreads by sharing personal belongings like towels and razors.

Symptoms

A localized skin infection due to MRSA may cause the following symptoms;

• Red patch
• Swollen
• Pain
• Pus-filled elevation in the skin
• Fever
• The area may be warm to the touch
• Tiredness
• Headache
• Body aches
• Chills
• Difficulty in breathing
• Chest pain
• Cough
• Skin rash

Medical help must be sought if pimples, insect bites, cuts, abrasions, wounds, scrapes, oozing fluid or pus are observed, especially in children.

A more serious and generalized infection occurs when MRSA invade the bloodstream to spread to various organs in the body.

Diagnosis

MRSA is diagnosed based on culture. This is a procedure by which the bacteria are isolated and grown in laboratory conditions from samples collected from patients or healthy carriers.

The samples usually collected for this include blood, sputum, urine, pus, or other fluids depending on where the infection is.

A swab may be taken from wounds or the skin surface.

Treatment

As the name implies, this strain of S. aureus is resistant to methicillin, an antibiotic used in the treatment of such infections.

• If the infection is a local one, say a skin sore, then that may be drained by making a surgical incision.
• More serious HA-MRSA infections may need treatment with other antibiotics to which they may be sensitive. These include clindamycin, daptomycin, doxycycline, linezolid, minocycline, tetracycline, trimethoprim-sulfamethoxazole, or vancomycin. These need to be taken in a proper and prescribed regimen to achieve complete results and prevent any further resistance.
• The widely spread and life-threatening infections need treatment with antibiotics given as an infusion or injection into the blood vessels. This needs hospitalization.
• ventilator support and Dialysis may be required if the infections involve Lungs or Kidneys.

Precautions

• In an MRSA skin infection, it is good to keep the wound, cut, or sore covered with a dry and sterile bandage till they heal.
• Covering the skin wounds helps to contain the spread of infection to others.
• One should avoid using a public swimming pool, a common bathing facility, saunas, spas, and whirlpools till the wounds heal completely.
• These wounds should not be frequently touched.
• Hands should be washed regularly especially so after handling the wound or after any accidental touch on the infected wound.
• Hand washing is best done with soap and water. Alternatively, a hand sanitizer with 60% alcohol may be used.
• Any belongings that have been exposed to MRSA should be cleaned properly. This is most ideally done with disinfectants, chemicals that kill or inactivate the germs on surfaces.
• Cleansers or sanitisers may be used.
• Only those that are safe for surfaces may be used with precaution using gloves or aprons if one is required.
• Hands should be washed with soap and water after any infected items are handled.

Treatment

MRSA can be prevented if proper care is exercised. One should be watchful if one ever gets hospitalized.

• It is good to remind and request healthcare workers to wash their hands before one is touched by them.
• One may even discuss with them how to safely remove the catheters, infusion ports, or catheters if any are used.
• All visitors to the hospital should be requested to wash hands.
• After discharge from a healthcare facility, one should be attentive to any signs of infections like fever, chills, malaise, or increased soreness around a wound.
• Medical help should always be sought if any sign of suspicion of infection occurs.
• To prevent the spread of infection and to keep away from acquiring an infection from others at home or in the community, one should avoid sharing personal belongings like razors, combs, towels, napkins, linen, utensils, bedding, clothing, or sheets.
• Any sports equipment if shared should be cleaned with cleaning agents. If there is somebody at home with an infection, the environment should be kept clean, ventilated, and hygienic.
• Bed rails, chairs, tables, and other surfaces should be regularly disinfected with proper chemical agents.
• The personal items of these patients should be handled only after wearing protective gloves.
• Hands should be washed with soap and water before and after handling any objects soiled with infectious fluids.

Signs and symptoms

Common signs and symptoms of POEMS Syndrome include:

• Weakness of nerves in the upper and lower limbs
• Darkening of the skin (hyperpigmentation)
• Thickening of the skin
• Abnormal fluid retention
• Increased hair growth (hypertrichosis)
• Elevated platelet count
• Shortness of breath
• Fluid accumulation around the Lungs (i.e. pleural effusion)

Causes

POEMS syndrome occurs due to the uncontrolled growth of monoclonal cells (plasma cells) leading to the accumulation of M-proteins (which fight infections) in the blood. A protein called Vascular Endothelial Growth Factor (VEGF) also causes angiogenesis leading to POEMS Syndrome.

Diagnosis

To diagnose POEMS Syndrome, your doctor may prescribe a few blood tests which include measuring vitamin B12 levels, VEGF levels, and haemoglobin levels.

POEMS syndrome diagnosis may be confirmed if your blood tests show:

• Low vitamin B12 levels
• Elevated VEGF levels
• Decreased haemoglobin levels

A Lumbar Puncture is performed to determine protein levels in Cerebrospinal Fluid (CSF).

Your doctor may also recommend Electromyography (EMG) for Neuropathy, Computed Tomography (CT) Scan and Bone Marrow Biopsy to diagnose the condition.

Treatment

The treatment for POEMS helps to relieve the symptoms but may not cure the condition. The treatment depends on the underlying plasma cell disorder. The treatment usually involves a combination of medical, surgical, and adjuvant therapies. Treatment options may also include Radiation Therapy, Chemotherapy, and Peripheral Blood Stem Cell Transplant.

Corticosteroids and low-dose alkylating agents are given followed by Chemotherapy. Systemic therapy can be given in the case of widespread osteosclerotic lesions.

If VEGF is the underlying cause, a monoclonal antibody such as bevacizumab may be prescribed by your doctor.

POEMS syndrome is a rare disease and research is still ongoing to identify the appropriate treatment for it.

Prevention

Early diagnosis of POEMS syndrome is very important as it progresses rapidly and may be life-threatening at times. This condition is often misdiagnosed as it mimics the symptoms of other conditions as well.

Causes

What causes PV is not fully understood. However, all patients with PV carry a mutation (change in the genetic material, DNA) in the JAK2 gene (Janus kinase 2 gene, which instructs in making a protein that promotes growth and cell division). This mutation is likely to play a major role in the onset of PV. But what initiates the disorder and what causes a change in the JAK2 gene is still unclear.

PV is not transferred from parents to children. However, occasionally more than one family member may suffer from PV.

Another type of PV called secondary PV, which is in no way related to JAK2 mutation, is caused due to long-term exposure to low oxygen environments like being in high altitudes, smoking, and severe Lung or Heart Disease.

Symptoms

The symptoms of PV develop slowly, and initially, it does not show any symptoms. When symptoms do show, they are due to thick blood that prevents easy blood flow to all parts of the body and deprives organs of sufficient oxygen-rich blood. Without oxygen, many organs do not function normally. PV can cause symptoms like:

• Difficulty breathing when lying down
• Shortness of breath
• Enlargement of spleen and/or Liver
• Blood clot in the veins (thrombosis)
• Heart Disease
• Dizziness
• Excess sweating
• Ringing in the ears (Tinnitus)
• Fatigue
• Feel full in the left upper abdomen
• Feeling itchy, especially after a warm bath
• Tingling or burning sensation in hands and feet
• Headache
• Inflammation of the joint
• Face changes to red colour
• Bluish discoloration of the skin
• Symptoms of phlebitis (inflammation of the walls of the vein, commonly seen in legs)
• Bleeding from gums and excess bleeding from small cuts
• Sudden unexplained weight loss
• Red spot on the skin
• Double vision/blurred vision

Diagnosis

As PV does not cause any signs and symptoms, it is diagnosed accidentally during blood tests done for other purposes.

PV is suspected based on the patient’s age, medical history, family history, physical examination, overall health, and a few tests.

During a physical examination doctor might look for an enlarged spleen, redness in the face, and bleeding from gums.

If PV is confirmed, then the next step is to find out whether it’s primary or secondary PV.

Differentiation is done by simple physical examination and medical history, if they do not provide conclusive results then the level of erythropoietin (EPO) hormone is checked.

A Complete Blood Count (CBC) is done to measure the level of haemoglobin and hematocrit (volume of RBC in blood). A high level of both suggests PV.

CBC can also provide information about the number of RBC, WBC, and platelets.

A blood smear is a microscopical study of the blood cells, which shows the number of blood cells, and any abnormality in the structure of blood cells. Abnormal types of blood cells are linked to myelofibrosis, a condition related to PV.

Erythropoietin level (EPO) is a hormone that stimulates bone marrow to make blood cells, measuring the level of EPO is an essential diagnostic procedure for PV.

A decreased level of EPO confirms primary PV; secondary PV has a normal or increased level of EPO. Bone marrow test shows whether the bone marrow is healthy and whether it’s making a normal amount of blood cells. Too many blood cells in the bone marrow confirm PV.

A genetic test that looks for the presence of JAK2 mutation is done. Elevated levels of WBC and platelets are seen in 50% of the patients.

Treatment

Treatment for PV is aimed at reducing the thickness of blood and preventing bleeding and clotting. Phlebotomy is one of the treatment options. During this procedure, a needle is inserted into the vein and some amount of blood is removed from the body into a sterile bag. This is done weekly and every time a pint (1 unit) of blood is removed until the hematocrit value is less than 45.

Drugs like hydroxyurea and interferon-alpha are prescribed, which keep the bone marrow from making too many blood cells.

Hydroxyurea is a Cancer drug that reduces the number of RBC and platelets and brings down the thickness of blood close to normal.

Interferon-alpha triggers the Immune System to fight against the bone marrow that is making too many blood cells.

Radiations usually suppress the overactive bone marrow and reduce the number of blood cells.

Prevention

Preventing primary PV is impossible, however, symptoms and complications can be prevented by taking proper treatment. Secondary PV can be prevented to an extent by avoiding all situations that deprive the body of oxygen for a long period.

Raynaud’s Disease can occur due to various conditions at the workplace. The repeated actions that can lead to Raynaud’s Disease are the use of tools that vibrate at work, playing the piano and typing for a long time. The chemicals that lead to this disorder are nicotine in cigarette smoke aids in the narrowing of blood vessels and exposure to vinyl chloride in the plastic industry. The causes can be damage to the nerves of the feet and hands due to working repeatedly over them. Diseases that cause Raynaud’s Disease are:

• Scleroderma - a skin disease caused by a disordered Immune System.
• Sjogren’s Syndrome - a disease that causes dryness of skin and mouth.
• Rheumatoid Arthritis - a disease affecting the joints caused by a disordered Immune System.
• Atherosclerosis - a condition that involves the deposition of fats in the walls of the blood vessels
• Buerger's Disease - inflammation of the blood vessels
• Dermatomyositis - a disease that causes inflammation of muscles and skin
• Carpal Tunnel Syndrome - a condition caused by the compression of the nerve that controls muscles of the wrist and palm
• Thyroid problems
• High Blood Pressure

In all these diseases, the blood vessels narrow down resulting in a lack of blood supply to the extremities. In severe cases of Raynaud’s Disease, permanent death of tissue occurs due to lack of blood supply which is known as Gangrene.

Raynaud’s Disease may also be the result of certain medications used in the treatment of Cancer, High Blood Pressure, cold and migraine, and contraceptive pills. Frostbite and injury caused due to certain surgeries of the extremities also cause Raynaud’s Disease.

Risk factors for Raynaud’s Disease

Raynaud’s Disease is commonly seen in women between 15 to 40 years of age, the reason is unknown. People having a family history of the disease and those who are living in colder climates are at higher risk.

People in occupations that involve repeated trauma to extremities due to the use of any tool that vibrates have a high risk of developing Secondary Raynaud’s Disease.

Other risk factors are diseases like Lupus and Scleroderma, exposure to chemicals like vinyl chloride in plastic industries and smoking.

Diagnosing Raynaud’s Disease

Raynaud’s Disease can be identified by the colour change of toes and fingers from the normal healthy pink to bluish purple colour on exposure to extreme cold or psychological stress.

Tests are conducted by the Rheumatologist (Doctor who treats disease of muscle, bone and joints) to diagnose Raynaud’s Disease. In the test known as the cold simulation test, the patient’s fingers are taped with cold sensors and then dipped in ice-cold water for some time. Then the fingers are removed from the ice water and observed for color change. If the patient has Raynaud’s Disease, it will take longer time than normal for the colour to change from bluish-purple to healthy pink.

In a test called nail fold capillaroscopy, the fingernails are observed under a microscope after putting a drop of oil at the base of the fingernail. If there is any disorder, then the blood vessels look inflamed under the microscope.

Blood tests are also conducted to check for any conditions of inflammation.

Treating Raynaud’s Disease

• A permanent cure for Raynaud’s Disease is not there, but you can avoid trigger factors to a large extent. When you go out in cold weather, you must wear warm gloves, scarf, coat, hat and mittens.
• Make sure the car is warmed when you drive out in chill weather.
• When you have to handle cold foods from the refrigerator, do so wearing warm gloves.
• Avoid air-conditioned places and keep yourself warm by wearing protective warm clothes.
• If you are working in industries in which you are exposed to chemicals, do wear protective gloves.
• The use of tools that vibrate in your workplace should be limited.
• Do consult your doctor when you need to take medicines for any other illness as certain medicines can trigger
• Raynaud’s Disease due to their blood vessel constricting nature. Similarly, psychological stress leads to the release of hormones that constrict blood vessels leading to Raynaud’s Disease.
• Keep away from stressful situations and practice relaxation and deep breathing techniques.
• When you find that your fingers and toes have started to become cold and blue, start rubbing them, put your hands under your armpit or place your fingers in warm water. You can shake and move your hands and legs in circles. This will generate heat.
• In severe cases, the tissue becomes dead which is also known as Gangrene. In such cases, surgery involving amputation of the affected part followed by antibiotic therapy is a must.

Life with Raynaud’s Disease

Life with Raynaud’s Disease can be easy if you know how to avoid the trigger factors. By taking all the precautionary measures, keeping stress at bay, and following the doctor’s advice, you can lead a normal healthy life.

Causes

Many causes contribute to the development of secondary hypertension which include:

Kidney Disease: Damage to the Kidneys results in the narrowing of renal arteries causing an increase in Blood Pressure.

Abnormalities of the adrenal gland: Adrenal glands secrete various hormones that regulate Blood Pressure. Adrenal Diseases such as Pheochromocytoma, Hyperaldosteronism, and hypercortisolism can alter Blood Pressure.

Diabetes complications: In the case of diabetic nephropathy, damage to Kidneys occurs leading to secondary hypertension.

HyperparaThyroidism: Parathyroid hormone regulates calcium and phosphorous levels in the body. If the hormone levels in the body increase, calcium levels also rise triggering High Blood Pressure.

Sleep apnea: In this condition, inhalation of oxygen decreases leading to damage of blood vessel linings. This damage ultimately causes a rise in Blood Pressure.

Obesity: The amount of blood circulation increases putting pressure on the arteries. This causes a rise in Blood Pressure leading to secondary hypertension.

Pregnancy: Women during pregnancy are also at risk of secondary hypertension.

Symptoms

Symptoms of secondary hypertension include:

• Persistent rise in Blood Pressure (systolic Blood Pressure > 180 mmHg; diastolic Blood Pressure >120 mmHg) even after using medications
• Sudden onset of High Blood Pressure before the age of 30 and after 55
• No family history of hypertension

Complications

The complications of secondary hypertension are damage to the arteries, formation of an aneurysm, weakened blood vessels in the eyes and Kidneys, Heart Failure, impairment of memory, and metabolic syndrome.

Diagnosis

Your doctor initially measures your Blood Pressure six to seven times at different visits. If the Blood Pressure is persistently high during all the measurements, your doctor may give the provisional diagnosis as secondary hypertension. Your doctor may also recommend following tests to confirm the diagnosis.

• Blood test – to check levels of electrolytes (sodium, potassium, calcium, and chloride), creatinine, blood urea nitrogen (BUN), blood glucose, cholesterol
• Urine test - to check for the markers of High Blood Pressure
• Ultrasound of Kidneys – to know whether the underlying cause is Kidney damage
• Electrocardiogram – to evaluate whether the underlying cause is a Heart problem
• Magnetic Resonance Angiography – in cases of renal stenosis

Treatment

The primary goal of the treatment of secondary hypertension is to treat the underlying cause. After diagnosis, your doctor recommends appropriate treatment for the cause (maybe adrenal gland abnormalities, Kidney Disease, Diabetes, or sleep apnea). Your doctor also prescribes antihypertensive medications such as diuretics, beta-blockers, angiotensin-converting enzyme (ACE) inhibitors, or calcium channel blockers.

If there is damage or narrowing of the arteries, your doctor may recommend surgery to correct the problem. If the secondary hypertension is drug-induced (caused by the use of any medication), then your doctor suggests to stop taking the medication decrease the dose of the medication or try to give any alternative medication.

Lifestyle modifications

To keep your Blood Pressure, adopt some measures:

• Eat healthy foods.
• Maintain a healthy weight.
• Perform regular physical activity.
• Reduce the intake of sodium in your diet.
• Stop smoking and alcohol consumption.
• Take Blood Pressure medication as prescribed.

Signs and symptoms

Common signs and symptoms of sepsis include a high (above 101 F) or a low body temperature (below 96.8 F), rapid breathing, increased Heart rate, and Edema.

In early stages or during severe sepsis, the symptoms seen are rapid Heart rate, decreased urination and increased blood sugar. In later stages or during septic shock, the signs include confusion, metabolic acidosis, decreased Blood Pressure, decreased cardiac output, and abnormal blood clotting.

Causes

The cause of sepsis is a bacterial, viral, or fungal infection. Gram-positive bacteria, mostly staphylococci are the common cause of infection. The infection originates in the Lungs (Pneumonia), the abdomen (abdominal infection), the bloodstream (bacteremia) or the Kidneys (Kidney infection). The common site of origin of infection is Lungs.

Risk factors

Sepsis is seen mostly in older adults, infants, and individuals with weakened or compromised Immune Systems. Using invasive devices such as catheters or breathing tubes and having wounds, burns, or injuries increase the risk of sepsis.

Complications

The sepsis may progress to septic shock due to decreased Blood Pressure. In this condition, there may be severe bruising and bleeding leading to tissue damage, organ failure and the formation of Gangrene. This condition is a life-threatening complication.

Diagnosis

Diagnosis of sepsis includes:

• Blood tests: It involves measurement of white blood cell (WBC) count, serum lactate and electrolytes. Culture tests are also performed to determine antibiotic treatment.
• Urinalysis: Urine tests are done to evaluate a urinary tract infection.
• Imaging tests: X-ray, computed tomography (CT), Magnetic Resonance Imaging (MRI), or ultrasound scans are performed to visualise the organs and determine the cause of the sepsis.

Treatment

Early diagnosis and prompt aggressive treatment for sepsis are essential to increase the chances of survival. The treatment of sepsis usually includes the use of antibiotics at home if it is detected in the early stages. Individuals who are diagnosed early can recover completely.

Individuals with severe sepsis and septic shock require admission into the intensive care unit (ICU). Treatment with intravenous antibiotics should be initiated immediately within six hours of admission. Initially, broad-spectrum antibiotics (act on most of the bacteria) are given and after obtaining the laboratory reports, bacteria bacteria-specific antibiotic is prescribed. If Blood Pressure is low during treatment, your doctor may prescribe vasopressors. Corticosteroids can also be given to reduce inflammation.

Intravenous fluids are given to restore fluid volume. This helps to regulate Blood Pressure, Heart rate, and urine output.

Apart from the administration of medication, there is a requirement to drain infected fluids and manage organ dysfunction. The management may involve hemodialysis in cases of Kidney dysfunction, ventilation in cases of Lung dysfunction, and blood product transfusion in cases of circulatory failure. If the blood sugar levels are high, your doctor recommends administration of insulin.

Common STDs

There is a wide range of the Sexually Transmitted Diseases list.

Chlamydia is caused by the bacteria Chlamydia Trachomatis, which infects the urinary tract in both men and women. Symptoms include painful urination and pain in the lower abdomen. In women, Chlamydia can cause pain during intercourse and vaginal discharge. Men have a discharge from the penis and testicular pain.

Gonorrhea is caused by the bacteria Neisseria Gonorrhoea and can infect the genital tract, mouth, and rectum of both men and women. Symptoms include a thick, cloudy, or bloody discharge from the penis or vagina, pain or burning sensations when urinating, frequent urination, and pain during sexual intercourse.

Syphilis comes from a spiral-shaped bacteria called Treponema pallidum. It appears with one or more lesions or ulcers around the genital area. Syphilis can be dormant for up to seven years between active outbreaks. Taking penicillin or a similar antibiotic can cure Syphilis, however, if left untreated Syphilis can cause severe complications including death.

Trichomoniasis is caused by the single-cell protozoa Trichomonas vaginalis. This disease affects both men and women, but most symptoms are found in women and include vaginal discharge, itching or irritation, pain during sexual intercourse, painful urination, and light vaginal bleeding.

Genital Herpes is a result of the Herpes Simplex virus. The signs of infection appear as one or more blisters on or around the genitals or rectum. These blisters form small, fluid-filled clusters that break open, leaving painful sores.

Human Papillomavirus, or HPV, is a viral infection that can appear in the mouth, throat, or genital areas of both men and women. In ninety per cent of cases, there are no outward symptoms. However, the disease can also manifest itself as warts on the genitals, or more rarely, in the throat. Certain strains of HPV can result in potentially life-threatening Cancers.

Hepatitis B is a Liver infection caused by the Hepatitis B virus. It is considered life-threatening, and, if untreated, can cause chronic Liver disease. Common symptoms include fever, fatigue, muscle or joint pain, loss of appetite, and mild nausea and vomiting. Serious symptoms that require immediate medical attention and possibly hospitalization include severe nausea and vomiting, yellow eyes and skin ("jaundice"), and a bloated or swollen Stomach.

Acquired Immune Deficiency Syndrome (AIDS) is caused by Human Immunodeficiency Virus (HIV) which progressively damages the Immune System and makes the body vulnerable to infections. It might take years for HIV to permanently damage the Immune System and develop into full-blown AIDS. Early symptoms include fever, headache, sore throat, swollen lymph glands, rashes, and fatigue. Once these early signs disappear, chronic symptoms may appear, such as Diarrhoea, weight loss, fever, cough, and shortness of breath. Symptoms in the later stages of HIV include fatigue, sweating at night, continued chills or fever, swelling of the lymph nodes for more than three months, Chronic Diarrhoea, and continued headaches. There is no cure for AIDS, however, there are ways to manage the disease so people stay healthier and live longer.

Symptoms

A few STD symptoms in men are:

• Painful urination
• Testicular pain in men
• Discharge from the penis

A few signs of STD in women are:

• Lower abdominal pain
• Vaginal discharge
• Bleeding between periods
• Pain during intercourse

Treatment of STDs

If you are concerned that you might have an STD, consult with your doctor immediately. Be honest and direct with your doctor. While this may be an unpleasant or awkward conversation to have, there are serious risks and consequences to delaying the treatment of an STD.

Causes for concern might include any of the symptoms listed above, a personal history of sexual encounters that could be considered high risk, or partners who have displayed any symptoms of having a Sexually Transmitted Disease. A doctor will be able to give a specific diagnosis and treatment, as well as provide support options for dealing with the disease.

The doctor or healthcare provider may order some laboratory tests to help diagnose the cause of any symptoms or infections. Most tests will collect blood samples, but sometimes testing fluids from active sores or scrapings may be necessary. Testing discharge may also be required for a confirmed diagnosis.

Most infections from bacteria or parasites will need antibiotic treatments. Viral STD infections are not curable but can be effectively controlled through vaccines. HIV infections are managed through antiviral and antiretroviral drugs which can lead to an improved quality of life.

Preventing STDs

Each year, millions of new cases of Sexually Transmitted Diseases are reported, yet STDs can easily be avoided. Some lifestyles can increase the odds of being exposed to an STD. These include being sexually active at an early age, lowering inhibitions by abusing alcohol and illegal drugs, and living in a community with a high rate of STDs because your risk of exposure goes up.

Safety tips include avoiding unprotected sex, not engaging in sex with multiple partners, and staying away from risky sexual practices. Of course, the only sure way to avoid an STD is to not have sex.

When engaging in oral, vaginal, or anal sex, always use latex condoms. Avoid condoms lubricated with spermicides because frequent use of some spermicides can increase the risk of HIV. And be aware that you can take vaccines to prevent STD infections such as hepatitis B and Human Papillomavirus, or HPV.

Symptoms of Syphilis

Syphilis may not show any symptoms for many years, so transfer of the infection occurs during sexual contact without the people being aware of the disease.

When the primary infection occurs, a sore or chancre is formed at the spot of entry of the infection. This chancre is small round and painless, and lasts for 3 to 6 weeks. Though it heals without treatment, it is advised to consult a doctor so that it doesn’t progress to the secondary stage of the disease.

If Syphilis progresses to the secondary stage, reddish brown rashes appear on the underside of feet and palms.

Associated symptoms with the secondary stage of Syphilis are;

• High fever
• Sore throat
• Swollen lymph glands
• Weight loss
• Pain in the muscles
• Extreme weakness
• Patchy hair loss
• Skin rash

If untreated, Syphilis moves on to the last stage which is also called as latent stage, where the symptoms of the disease are completely hidden for years. The disease resurfaces only after 10 to 20 years.

The last stage is characterized by damage to different organs of the body like Heart, Brain, Liver, eyes, nerves, blood vessels, joints and bones.

The signs of the last stage are;

• Gradual blindness
• Paralysis
• Numbness
• Difficulty in moving muscles
• Dementia

If untreated at this stage, it leads to the death of the patient.

Diagnosing Syphilis

To diagnose, the physician may collect fluid discharge from the chancre and observe it under the microscope.

The bacteria Treponema pallidum can be seen if the person has Syphilis.

After the Syphilis infection occurs, the body produces antibodies in response to the infection. These antibodies can be detected by a blood test.

A pregnant lady should go for a blood test for detection of Syphilis as the disease if left untreated, may cause the death of the baby.

Treating Syphilis

In the primary stages of Syphilis, it is much easier to treat it. An antibiotic injection like penicillin is given to Syphilis patients who have had the disease for less than one year. Only one shot is required. For people suffering for more than a year, more shots are needed. If the patient is allergic to penicillin, other antibiotic injections are given. The treatment effectively kills the bacteria and prevents further complications.

People who are diagnosed with Syphilis should not have sexual intercourse with new partners, till the treatment for the sores is complete.

For pregnant women with Syphilis, treatment should be started immediately. There is a possibility of reinfection after the treatment, due to some bacteria hidden in the genital areas or mouth. Hence, to confirm if the disease is completely gone, the doctor conducts blood tests at regular intervals.

Transmission of Syphilis

Syphilis spreads through unsafe sexual contact. To protect yourself from the spread of the disease, it is advised that you use condoms during sexual intercourse, and dental dams during oral sex.

You must talk to your sex partner if you have Syphilis. It is essential that your partner also gets tested for the disease.

The infectious chancres should be covered by a bandage to prevent the spread of infection.

A pregnant mother with Syphilis can spread it to her baby. Consult your doctor immediately when you find any symptoms of the disease.

Syphilis and HIV

In Syphilis infected sores or chancres are exposed, and it is easier for HIV or any other Sexually Transmitted Disease to penetrate through these sores during sexual intercourse with an infected partner. It is advised that people with Syphilis also undergo diagnostic tests for HIV, Gonorrhea and Chlamydia.

Preventing Syphilis

• To prevent Syphilis, it is advised that you have sexual intercourse with a single uninfected partner.
• Practising safe sex is the best way to prevent Syphilis. When you are having sexual intercourse, use a latex condom in the case of males, and a polyurethane condom in the case of females.
• For oral sex, use dental dams that offer protection.
• Talk about safe sex with your partner.
• Regular check-ups at the doctor’s clinic are advised.
• Stay away from drugs and alcohol abuse, as they can lead to situations of unprotected sexual activity with multiple partners.

Prevention is better than cure

As the saying goes, ‘Prevention is better than cure’, sexual partners must take all the necessary precautions to avoid Syphilis and other Sexually Transmitted Diseases. The best gift you can give your sexual partner is to practice safe sex.

Signs and symptoms

Tetanus symptoms usually occur within 4 to 21 days (an average of 10 days) after infection. The main symptoms of Tetanus include:

• stiffness in jaw and neck muscles which makes it difficult to open your mouth
• painful muscle spasms that cause difficulty in swallowing and breathing
• unusual sweating
• a rapid Heartbeat (tachycardia)
• a high body temperature of 38oC (100.4oF) or above

Causes

The bacterium which causes Tetanus is Clostridium tetani. It is commonly found in soil and the faecal excreta of cows and horses. It can stay alive for a long time outside the body. If you’re infected, the bacteria enter your bloodstream through the wound and multiply quickly. The toxins released by these bacteria affect the nerves, producing symptoms such as muscle stiffness and spasms.

Tetanus infection can occur when there are

• burns
• cuts and scrapes
• tears or splits in the skin
• eye injuries
• injection of contaminated drugs
• insect or animal bites

Tetanus is not contagious, i.e. it does not spread from person to person.

Risk factors

Most of the cases of Tetanus are recorded in people who do not get vaccinated. Missing either an initial immunization or a booster dose can increase the risk.

You are also more likely to have Tetanus if you have an injury that paves the way for the entry of the bacterial spores. The use of illegal drugs is another risk factor for Tetanus infection.

Diagnosis

Based on your symptoms, your physician will ask about your medical history and perform a physical examination. A laboratory test may not help to diagnose Tetanus. But to rule out other conditions with similar symptoms, lab tests may be performed.

Treatment

If you are at risk of developing Tetanus but do not have any associated symptoms, then your doctor will clean the wounds and give you a Tetanus immunoglobulin injection. Also, a dose of the Tetanus vaccine will be given if you haven’t taken one in the past.

If your doctor suspects Tetanus, then you will be admitted to the intensive care unit (ICU) and the following Tetanus treatment is provided:

• antibiotics such as penicillin to kill the bacteria
• Tetanus injection containing immune globulin to neutralize the bacterial toxins
• muscle relaxants to relieve muscle spasms and stiffness
• a ventilator to support breathing

Complications

The serious health complications that can result from severe muscle spasms associated with Tetanus are:

• breathing problems as a result of spasms of the vocal cords
• Abnormal Heart rhythms
• Brain damage due to poor oxygen supply
• secondary infections due to extended stay in the hospital
• Pneumonia (an infection of the Lungs)
• bone fractures

Self-management

You may take some steps for the prevention of Tetanus infection when you have a wound, such as:

• Applying pressure to control bleeding
• Keeping the wound clean
• Using antibiotics
• Covering the wound
• Regularly changing the dressing

Prevention

Vaccination is the only way to prevent Tetanus infection. The Tetanus vaccine in children is administered along with diphtheria and acellular pertussis (DTaP) vaccine. It is administered at the ages of two months, four months, six months, 15 to 18 months, and four to six years.

The booster shots of the Tetanus vaccine are given in combination with the diphtheria vaccine (Td). It is administered at the ages of 11 and 12, and then a TD booster after 10 years.

Symptoms

TBDs have some common symptoms. They are:

• Fever
• Chills
• Headache
• Tiredness
• Body aches
• Joint pain
• Skin rash
• Ulcer

Other complaints may include:

• Vomiting
• Pain abdomen
• Diarrhoea
• Stiff neck
• Facial Paralysis

The symptoms may range from mild to severe; the latter may need hospitalization.

Diagnosis

Diagnosis is generally clinically based on the presenting symptoms. Complaints in people known to be engaged in vulnerable activities or staying in geographic regions with tick populations are viewed with suspicion.

Laboratory tests help to supplement the clinical diagnosis.

Blood tests may reveal a low count of different blood cells.

Specific tests for infections include those that measure the amounts of antibodies. These are specific proteins produced in the body in response to infections and these help to fight infections.

Specific protein components of invading germs may be tested in the blood. The tests for such analysis include western blot, enzyme-linked immunosorbent assay (ELISA), immune fluorescent assay (IFA), and polymerase chain reaction (PCR).

In some cases, the causative organisms may be isolated from blood or other samples, and grown in the laboratory to study their characteristics. This is called culture.

Treatment

Below mentioned are a few medicines for the treatment of Lyme Disease.

TBDs are treated with medicines called antibiotics. These help to fight infection by either checking the multiplication of or by killing the causative germs.

Some antibiotics used in various TBDs are amoxicillin, doxycycline, chloramphenicol, rifampin, tetracycline, or streptomycin. These should be taken as advised by the doctor and for the prescribed duration.

Prevention

TBDs can be prevented by exercising some precautions.

• It is good to avoid areas with a high density of ticks.
• When working or going to such areas, wood or bushy areas should be avoided.
• Walking through grass and leaf litter should be avoided.
• Bushes should be cleared around the house.
• Old furniture and trash should be removed from the yard.
• Toys and swings of children should be kept away from trees and yard fencing.
• The lawns should be mowed regularly to prevent the grass from excessive growth.
• Chemical repellents with DEET (N, N-diethyl-m-toluamide) or permethrin are known to be effective.
• Clothes, boots, belongings, tents, etc can be treated with permethrin.
• Products containing 20% or more DEET can be applied on the skin. These should be used as per the instructions on the label. These afford protection for several hours.
• Bathing or showering after every visit outdoors can reduce the risk of infections. The ticks can be looked for on the body and picked up to remove them.
• Light-coloured clothing should be worn so that the ticks can be easily identified when seen crawling on the body.
• Ticks should never be squeezed or crushed while removing them, as harmful materials from them can infect the skin.
• Clothes may be tumbled in a dryer on high heat for an hour to kill the ticks.
• A full-body tick check may be done with a hand-held mirror.
• Children should be screened for ticks around the arms, in and around the ears, belly button, between legs, and in hair.
• Ticks may get stuck to the fur of pets like dogs. Tick diseases in dogs are a common condition. Any pets should be regularly checked for ticks. The pet should be kept under watch for any change in behaviour if suspected to have been bitten by a tick.
• They should be taken to a veterinarian for management and precaution.
• These precautions are essential for people living or working in regions with high tick densities.
• These are more important in the warm months from April to September as ticks are more active at this time of the year.

Outlook

Tick-borne diseases, although not serious, may be very troublesome. If you stay in a region known to have tick populations, take care that you, your children, and your pets are safe from tick-borne diseases. People should be watchful of the symptoms, if any appear, consultation with a doctor is necessary. Most of the tick-borne diseases can be treated effectively.

Knowing Trichomoniasis

Trichomoniasis is a widely prevalent genital infection, also called Sexually Transmitted Disease (STD) that is caused by a parasite called Trichomonas vaginalis, which is invisible to the naked eye. It is more common and evident in sexually active young women though men are not spared.

Symptoms

The commonest trichomoniasis symptoms in women are;

• Copious foamy or frothy foul-smelling yellowish-grey, vaginal discharge
• Vaginal itching
• Burning
• Pain during urination
• Pain during intercourse

In some women and most men, the infection may be deceptively silent. Some men may complain of a discharge from the urethra, pain in the genitals, or pain or burning with urination.

Transmission of infection

Trichomoniasis spreads from person to person, usually by sexual exposure. People with multiple sexual partners are more susceptible to acquiring the infection. Usually, females spread the infection to their male partners. Infected females can spread the infection to other females if there is a homosexual relationship.

The infection is unlikely to be acquired by contaminated douche nozzles or toilet seats. The parasite is not viable for long outside the human body, so the chances of person-to-person spread are more than those due to an inanimate object.

Newborns can get the infection from infected mothers and children may get one due to sexual abuse.

Diagnosing Trichomoniasis

Trichomoniasis when symptomatic can be strongly suspected, and can be diagnosed by clinical history, and examination.

The diagnosis can be confirmed by observing the discharge under a microscope when the parasites can be seen and easily recognized due to the typical pear shape and presence of a few whip-like structures called flagella.

The doctor may ask about your sexual practices and inspect the genitals. A cotton-tipped swab stick may then be used to collect a sample of the discharge which is then laboratory tested. Alternatively, some rapid diagnostic tests may be used. When the microscopic examination is negative yet the infection is strongly suspected, the doctor may subject the samples to culture.

The doctor will also like to determine the pH of the vagina which gives an estimate of the acidic status of the secretions. The normally acidic pH of the vagina may become higher to acquire a more basic nature in trichomoniasis though this is not specific to the infection.

Additionally, your doctor may like to confirm that other STDs like HIV, Gonorrhoea, or Syphilis are not coincidentally present and may advise testing for the same. This is because trichomoniasis increases the risk of transmission of other STDs due to common unsafe sexual practices.

Since men are often symptomless, men need to be screened and evaluated for the infection and your doctor may advise you or your male partner for the same.

Urine may test positive for trichomoniasis in around 60-70% of cases.

Treating Trichomoniasis

Trichomoniasis is treatable. All symptomatic and asymptomatic cases and their contacts should be treated.

You may need to take a single dose (2g) of an antibiotic called metronidazole or tinidazole. Alternatively, metronidazole can be taken in a dose of 500 mg twice daily for 5-7 days. These medications tend to interfere with the vital processes in the parasite and ultimately kill them. Cure rates with these are good.

In tougher infections, a repeat course may help. Alternatively, an extended treatment may be advised. Reinfection should be excluded before beginning any extended regimens.

A common side effect of metronidazole or tinidazole can be a bitter taste in the mouth. You should also abstain from alcohol for at least 3 days when undergoing trichomoniasis treatment with metronidazole or tinidazole.

Consumption of alcohol when taking these drugs can lead to vomiting, headaches, and flushes.

You may be advised of a concomitant local application of gels. Used alone, the results of local therapy are not good but when used with oral treatment, the results are encouraging.

You should abstain from sex when undergoing treatment. Your partner also needs to be treated, even if symptom-free. You and your partner can resume sex when the treatment is complete and both of you are free of any symptoms.

If you are pregnant, you should ideally avoid taking metronidazole in the early months as it can lead to malformations in the developing baby. However, when the benefits of treatment outweigh the risks, you may be advised to take a 2 g dose. If you Breastfeed your baby, you may need to transiently stop Breastfeeding for a few days when undergoing treatment.

Left untreated, trichomoniasis can spread to the adjacent urinary and other reproductive organs. If not treated well in pregnancy, it can lead to pre-term delivery and low birth weight in the baby and can infect the baby. Trichomoniasis increases the risk of transmission of other STDs like HIV.

Preventing another Trichomoniasis infection

If you have once suffered from trichomoniasis, you may be at risk of acquiring the infection for the second time, if safe sex is not practised.

Immunity to reinfection does not develop after the first episode. The best way to prevent a reinfection is to practice safe sex.

Always use a condom. This will not only prevent a second infection with trichomonas but will also safeguard against the spread of other STDs like HIV.

Use a fresh condom every time you have sex.

Practice safety in oral sex. Cover the penis with a condom or vulva with a dam.

Avoid sharing vaginal douches or sex toys.

Prefer monogamous relations.

Go for regular sexual checkups, especially if you have multiple sexual partners. Anytime, if test positive for infection, inform your sexual partners to undergo treatment.

If you develop any symptoms like profuse discharge or a burning or pain in your genitals or notice any local ulcers, abstain from sex and seek medical consultation.

Abstain from sex when on treatment to prevent reinfection. Even if you are on a single-dose treatment with metronidazole, you may need to refrain from sex for a week. Treatment reduces the spread of infection.