Lymphatic filariasis is a parasitic disease caused by microscopic,
thread-like worms. There are three different species that can infect
humans. Most of the infections worldwide are caused by Wuchereria
bancrofti. In Asia the disease can also be caused by Brugia malayi and
Brugia timori. The infection spreads from person to person by mosquito
bites. The adult worm lives in the human lymph vessels where it mates
and produces millions of microscopic worms also known as microfilariae.
These circulate in the person's blood and infect the mosquitoes when
they bite, and they pass the infection to other people. Adult worms can
live for five to seven years. Many bites over several months to years
are needed for infection to occur so travelers to these areas are
normally at low risk.
The parasite damages the lymph system. People
with active infection may have fever, chills, headache and skin lesions
while many show no symptoms at all. If the infection goes untreated
then complications like lymphedema and elephantiasis can develop. This
is caused by fluid collection due to improper functioning of the lymph
system as a result of damage from the infection. The swelling usually
affects the legs but can also affect the arms, breasts and genitalia.
The swelling and the reduced function of the lymph system make it harder
for the body to fight infection so these people are more prone to
bacterial infections in the skin and lymph system. Good skin hygiene and
exercise can help prevent this. When the skin hardens and thickens it
is called elephantiasis. Men can develop swelling of the scrotum, called
a hydrocele. People can also develop a complication called tropical
pulmonary eosinophilia. This causes cough, shortness of breath, and
wheezing and occurs more commonly in those infected in Asia.
Diagnosis is confirmed using blood collected at night that is stained
with Giemsa or hematoxylin and eosin and examined under the microscope
for detection of microfilariae. People with active infection also have
increased levels of antifilarial IgG4 which can also be detected in the
blood. People with lymphedema often test negative because these
complications often develop years after an active infection.
Treatment is with albendazole and ivermectin or with diethylcarbamazine
(DEC). Doxycycline has also shown effectiveness. Treatment is only given
to those with active infections. Patients with complications for
untreated infections should be treated symptomatically. Patients with
lymphedema and elephantiasis benefit from good hygiene, exercise and
wound management. Patients with hydrocele normally require surgical
management.
The best prevention is to avoid mosquito bites. These
mosquitoes typically bite between dusk and dawn. You should sleep in an
air conditioned room if possible under a mosquito net. Wear long sleeves
and pants when out at night and use mosquito repellent on unprotected
skin. In some areas that are highly endemic annual mass treatment with
antifalarial medications is given.
Sunday, September 27, 2015
CAFFEINE INTAKE
Caffeine is a substance that is found naturally in certain plants such
as tea leaves, coffee, and cocoa beans. It can also be man made and
added to foods and drinks. Caffeine is a central nervous system
stimulant and a natural diuretic ( a substance that helps rid your body
of fluids). Caffeine has no nutritional benefit and can be avoided. It
is quickly absorbed and passes quickly into the brain. It does not
collect in the bloodstream or get stored in the body. It is passed from the body in urine many hours after being consumed.
Excessive caffeine may cause a fast heart rate, anxiety, depression, trouble sleeping, nausea, restlessness, tremors, frequent urination and vomiting. Suddenly stopping caffeine intake can cause withdrawal symptoms like drowsiness, headaches, irritability, nausea and vomiting. Large amounts of caffeine consumption can interfere with the absorption of calcium and lead to osteoporosis (thinning of bones). In women excess caffeine may also cause painful, lumpy breasts (fibrocystic disease). Caffeine in children can decrease their appetite and lead to decreased nutrition as soda may take the place of nutritional drinks such as milk or juice.
Moderate consumption of caffeine is not likely to be harmful as long as you observe other healthy habits (2-3 8 ounce (240 ml) cups of coffee or 5 servings of soda or tea). Though be aware that soda still contains a lot of calories and excess consumption may contribute to obesity.
Caffeine has also been added to medications used to treat headaches and has also been shown to be beneficial in treatment of asthma.
Excessive caffeine may cause a fast heart rate, anxiety, depression, trouble sleeping, nausea, restlessness, tremors, frequent urination and vomiting. Suddenly stopping caffeine intake can cause withdrawal symptoms like drowsiness, headaches, irritability, nausea and vomiting. Large amounts of caffeine consumption can interfere with the absorption of calcium and lead to osteoporosis (thinning of bones). In women excess caffeine may also cause painful, lumpy breasts (fibrocystic disease). Caffeine in children can decrease their appetite and lead to decreased nutrition as soda may take the place of nutritional drinks such as milk or juice.
Moderate consumption of caffeine is not likely to be harmful as long as you observe other healthy habits (2-3 8 ounce (240 ml) cups of coffee or 5 servings of soda or tea). Though be aware that soda still contains a lot of calories and excess consumption may contribute to obesity.
Caffeine has also been added to medications used to treat headaches and has also been shown to be beneficial in treatment of asthma.
CONGENITAL SYPHILIS
Congenital syphilis occurs when a mother's syphilis goes untreated
during pregnancy and is passed to the baby through the placenta or
during labor and delivery. Nearly half of infants that are infected
while in the womb die shortly before or after birth. Babies that are
infected at delivery have a better prognosis.
Symptoms of syphilis infection in newborns include failure to gain weight, fever, irritability, no bridge to the nose (saddle nose), rash of the mouth, genitals and anus, and a rash which begins as small blisters on the palms and soles which later changes to a copper-colored, flat or bumpy rash, and a watery discharge from the nose. Complications of syphilis in these infants can cause blindness, deafness, facial deformities, and nervous system problems.
If syphilis infection is suspected at birth then the placenta may be examined for signs of the infection. Upon exam the infant may be noted with signs of liver and spleen swelling and bone inflammation. Dark-field examination will be used to look for syphilis bacteria under the microscope. Bone x-rays, eye exams and lumbar puncture may be useful to assess for complications related to syphilis infection.
The normal treatment of syphilis in infants is Penicillin administered intramuscularly. However, developmental symptoms present are likely to be permanent. If undetected and left untreated then the syphilis infection will cause further complications, often neurological.
Routine screening for syphilis in pregnant women is the best prevention of congenital syphilis as this allows for treatment of the infected mother. If treated before the 16th week of pregnancy then the chances of the infection spreading to the unborn child is minimal. Safer sexual practices are also important in prevention. Uninfected mothers=uninfected babies.
Symptoms of syphilis infection in newborns include failure to gain weight, fever, irritability, no bridge to the nose (saddle nose), rash of the mouth, genitals and anus, and a rash which begins as small blisters on the palms and soles which later changes to a copper-colored, flat or bumpy rash, and a watery discharge from the nose. Complications of syphilis in these infants can cause blindness, deafness, facial deformities, and nervous system problems.
If syphilis infection is suspected at birth then the placenta may be examined for signs of the infection. Upon exam the infant may be noted with signs of liver and spleen swelling and bone inflammation. Dark-field examination will be used to look for syphilis bacteria under the microscope. Bone x-rays, eye exams and lumbar puncture may be useful to assess for complications related to syphilis infection.
The normal treatment of syphilis in infants is Penicillin administered intramuscularly. However, developmental symptoms present are likely to be permanent. If undetected and left untreated then the syphilis infection will cause further complications, often neurological.
Routine screening for syphilis in pregnant women is the best prevention of congenital syphilis as this allows for treatment of the infected mother. If treated before the 16th week of pregnancy then the chances of the infection spreading to the unborn child is minimal. Safer sexual practices are also important in prevention. Uninfected mothers=uninfected babies.
FOLIC ACID
Since I have gotten several questions and comments from women who are in
the child bearing period or who have recently had children I just
wanted to take the time to post on this important topic.
Folic acid is a B vitamin that helps the body make healthy new cells. It is found naturally in some foods but most women do not get all the folic acid they need from food alone. Folic acid is needed by everyone but is most important for women of childbearing age.
When a woman has enough folic acid in her body before and during pregnancy it can prevent major birth defects called neural tube defects. Spina bifida is one of these and happens when a baby's spinal cord does not close causing nerves that control leg movement and other functions to be damaged. These children often require many surgeries and have life long disabilities. Anecephaly is another and is when most or all of the brain does not develop. These babies die before or shortly after birth. Women need 400-800 mcg daily to help prevent these. Folic acid also helps to prevent anemia and is thought to help heart health and prevent cancer.
Folic acid occurs naturally in green leafy vegetables, citrus fruits, beans, whole grains, enriched cereals, breads, rice and pasta. Diet alone is not enough so don't forget to take your folic acid. If you take it the same time everyday then it will become part of your routine. Even if you are past childbearing age you will still benefit from taking 400mcg of Folic Acid daily to help maintain healthy blood. Men will also benefit from this.
Folic acid is a B vitamin that helps the body make healthy new cells. It is found naturally in some foods but most women do not get all the folic acid they need from food alone. Folic acid is needed by everyone but is most important for women of childbearing age.
When a woman has enough folic acid in her body before and during pregnancy it can prevent major birth defects called neural tube defects. Spina bifida is one of these and happens when a baby's spinal cord does not close causing nerves that control leg movement and other functions to be damaged. These children often require many surgeries and have life long disabilities. Anecephaly is another and is when most or all of the brain does not develop. These babies die before or shortly after birth. Women need 400-800 mcg daily to help prevent these. Folic acid also helps to prevent anemia and is thought to help heart health and prevent cancer.
Folic acid occurs naturally in green leafy vegetables, citrus fruits, beans, whole grains, enriched cereals, breads, rice and pasta. Diet alone is not enough so don't forget to take your folic acid. If you take it the same time everyday then it will become part of your routine. Even if you are past childbearing age you will still benefit from taking 400mcg of Folic Acid daily to help maintain healthy blood. Men will also benefit from this.
HYPOTHYROIDISM
Hypothyroidism is when your thyroid doesn't produce enough hormones.
Some causes of this include insufficient iodine in the diet, an
autoimmune condition called Hashimoto's thyroiditis, previous treatment
with radioactive iodine, injury to the hypothalamus or anterior
pituitary gland, certain medications, previous thyroid surgery or lack
of a functioning thyroid at birth. Diagnosis is confirmed using blood
tests measuring thyroid stimulating hormone (TSH) and thyroxine levels.
Common symptoms associated with hypothyroidism include fatigue, weakness, weight gain or trouble losing weight despite reduced food intake, coarse, dry hair and skin, sensitivity to cold, muscle cramps and aches, constipation, depression, irritability, memory loss, abnormal menstrual cycles and decreased libido. Severe cases of hypothyroidism may have jaundice, slowed speech and an increase in tongue size.
Standard treatment for hypothyroidism involves daily use of the synthetic thyroid hormone levothyroxine. This medication restores adequate hormone levels reversing the symptoms of hypothyroidism. Treatment is usually lifelong, but you will need monitoring of your TSH to ensure proper dosage of the medication. After initial treatment you will probably have a level checked after 2-3 months and repeated as needed until stable. Once levels stabilize monitoring can be done on a yearly basis.Generally this medication should be taken on an empty stomach at least 30 minutes prior to breakfast. Some medications such as iron supplements, calcium supplements, cholestyramine and antacids can interfere with your ability to absorb levothyroxine so should not be taken at the same time.
Hypothyroidism may be prevented in the general population by adding iodine to commonly used foods, for example iodized salt. Screening for hypothyroidism is performed in newborns in many countries. Early identification can prevent many developmental delays that may occur because of this condition if it is left untreated.
Common symptoms associated with hypothyroidism include fatigue, weakness, weight gain or trouble losing weight despite reduced food intake, coarse, dry hair and skin, sensitivity to cold, muscle cramps and aches, constipation, depression, irritability, memory loss, abnormal menstrual cycles and decreased libido. Severe cases of hypothyroidism may have jaundice, slowed speech and an increase in tongue size.
Standard treatment for hypothyroidism involves daily use of the synthetic thyroid hormone levothyroxine. This medication restores adequate hormone levels reversing the symptoms of hypothyroidism. Treatment is usually lifelong, but you will need monitoring of your TSH to ensure proper dosage of the medication. After initial treatment you will probably have a level checked after 2-3 months and repeated as needed until stable. Once levels stabilize monitoring can be done on a yearly basis.Generally this medication should be taken on an empty stomach at least 30 minutes prior to breakfast. Some medications such as iron supplements, calcium supplements, cholestyramine and antacids can interfere with your ability to absorb levothyroxine so should not be taken at the same time.
Hypothyroidism may be prevented in the general population by adding iodine to commonly used foods, for example iodized salt. Screening for hypothyroidism is performed in newborns in many countries. Early identification can prevent many developmental delays that may occur because of this condition if it is left untreated.
CHANCROID
Chancroid is a bacterial infection caused by the bacterium Haemophilus
ducreyi. The infection is spread through sexual contact, and is commonly
found in developing countries and high risk sexual groups like
prostitutes.
Symptoms typically begin 5-7 days after exposure. Men may notice a small red bump on the genitals and it may be found on either the scrotum or penis. This bump usually develops into an open sore or ulcer within a few days. Women often develop several red bumps on the labia or on the thighs. Once the bumps develop into an ulcer a painful burning sensation may be present during urination and sexual intercourse. The ulcers often bleed easily if they are touched or bumped. Swelling in the groin may also be present. The lymph nodes in the groin may also enlarge and can break through the skin and form draining abscesses.
Diagnosis is made by exam and can be confirmed by culturing the drainage from the ulcers and abscesses. Treatment is antibiotic therapy and can be given as azithromycin 1 g orally in a single dose or 1 g of ceftriaxone given intramuscularly, ciprofloxacin 500 mg orally twice daily for three days or oral erythromycin for seven days. Lymph abscesses may requires surgical irrigation and debridement. Recently erythromycin resistance has been noted. Treatment is often more complicated in patients with HIV co-infection and having chancroid increases the risk of HIV transmission.
The best way to prevent this infection is to use safe sexual practices, like condoms during intercourse and limiting sexual intercourse to a single monogamous partner. Avoid other high risk activities like drug abuse and alcohol abuse.
Symptoms typically begin 5-7 days after exposure. Men may notice a small red bump on the genitals and it may be found on either the scrotum or penis. This bump usually develops into an open sore or ulcer within a few days. Women often develop several red bumps on the labia or on the thighs. Once the bumps develop into an ulcer a painful burning sensation may be present during urination and sexual intercourse. The ulcers often bleed easily if they are touched or bumped. Swelling in the groin may also be present. The lymph nodes in the groin may also enlarge and can break through the skin and form draining abscesses.
Diagnosis is made by exam and can be confirmed by culturing the drainage from the ulcers and abscesses. Treatment is antibiotic therapy and can be given as azithromycin 1 g orally in a single dose or 1 g of ceftriaxone given intramuscularly, ciprofloxacin 500 mg orally twice daily for three days or oral erythromycin for seven days. Lymph abscesses may requires surgical irrigation and debridement. Recently erythromycin resistance has been noted. Treatment is often more complicated in patients with HIV co-infection and having chancroid increases the risk of HIV transmission.
The best way to prevent this infection is to use safe sexual practices, like condoms during intercourse and limiting sexual intercourse to a single monogamous partner. Avoid other high risk activities like drug abuse and alcohol abuse.
Subscribe to:
Comments (Atom)