Disease Informations

What is Dengue Fever? | Dengue Fever Preventions

2010-11-02T21:41:00.000-07:00

Tags: Dengue Fever | Dengue Precautions | Safety Measures

Dengue Fever is a sensitive viral disease caused by dengue viruses. Patients with dengue can pass on the virus only during mosquitoes or climate change and only even as they are still fever. Below is some Prevention for Dengue.

Water storage containers should be covered to prevent reproduction of mosquito’s.
Anti liquid spray should be implemented directly on the mosquito for successful killing.
Visit your doctor at the earliest and always appeal a blood test for better relief.

Home Prevention for Dengue

Mosquito coil and electric mosquito mats/ liquid should be placed near all possible entrances, such as windows and doors.

Treatment of Constipation

2009-11-24T22:19:00.000-08:00

Treatment of Constipation

Frequently simply increasing the amount of water and fiber in your diet can really improve your symptoms.
The key is balance - you don’t want to increase your daily consumption by simply dispersing brainpower across everything… try and step by step introduce foods high in fiber.
Fiber appends are often suggested but can take more than 2 weeks to accomplish full strength. These are neither disadvantageous nor addictive.
Try to stay active - even taking a fresh walk after dinner can help tone your muscles, which helps the pass through of your food.
Try not to ‘keep’ or confuse going for long periods of time - sometimes this cannot be helped, but the longer your stool passes inside your body, the more water gets absorbed from it and the harder it comes.

Symptoms of Constipation

2009-11-24T22:17:00.000-08:00

Symptoms of Constipation

Anal itchiness
Anal hurt or pain, particularly while sitting
Shiny red blood on toilet tissue, stool or in the toilet pipe bowl
Pain during bowel movements
One or more hard caring swellings near the anus
Unreasonable distorting
Small, dry, hard stools
Stomach ache/pain
Pain
Feeling like you aren’t finished
Painful bottom (maybe bleeding)
Leaking out of liquid or loose stool
Infrequent stools
Difficulty defecating/ needing to strain
Frequent ineffective defecation/ incomplete evacuation (‘sense’ of incomplete evacuation)
Decreased gastric emptying
Vomiting
Aspiration pneumonia
Hemorrhoids

Preventing of Constipation

2009-11-24T22:16:00.000-08:00

Preventing of Constipation

Take enough fiber in diet
Exercise regularly
Stool softener e.g. easy laxative: magnesia milk
Drink enough of water
Go to the bathroom when you have the urge
Eat a high-fiber diet of fruits, vegetables, whole grains
Avoid strain during bowel movement
Exercise daily
Drinking enough water at least 8 glasses per day

Causes of Constipation

2009-11-24T22:13:00.000-08:00

Causes of Constipation

Low consumption of cellulose/fiber
Low consumption of water
Changes of diet
Taking medicine
Lack of exercise
Stress and travel
Delay in going to the bathroom when having the urge to defecate
During pregnancy and after childbirth
Distortion during bowel movement
May result from constipation
Sitting for long periods of time
Anal infection
Poor fiber consumption in the diet
Poor fluid consumption
An inactive lifestyle
Environmental changes
Life-style/routine changes
Certain medications

Additional matters that add:

Change of location
Pregnancy
Change in diet
Repetition ignoring the urge to open your bowels
Deficiency of interest in eating
Lots of convenience foods
Getting aged
Poor dentition so unable to chew harder foods

Constipation

2009-11-24T22:08:00.000-08:00

Constipation

Occasional or difficult stools or trouble passing stools. Constipation could affect pain during the passing from a bowel movement; Constipation is having difficulty opening your bowels. This usually leads to you going to the toilet less often, unfitness to pass a bowel movement after distorting or pushing for more than 10 minutes, or no bowel movements after more than 3 days.
It is normal to open your bowels anywhere between 3 times a days to 3 times a week- it does not matter how much is normal for you; the trouble arises when you get less common and need to strain.
It is normal to get this at times, but if you need to strain more than a quarter of the time it becomes a trouble
Stool Chart

Diarrhea Preventing and Interventions

2009-11-18T00:08:00.000-08:00

Diarrhea Preventing

Washing hands regularly, using soap and hot water, always wash your hands:

After using the toilet
Before touching food.
After gardening
After playing with pets
Teach your child to wash their hands regularly and properly

Also prevent from spreading germs by:

Cleaning the toilet with antiseptic after using it
Not sharing towels
Vaccinate all children
Exclusive breast-feeding

Diarrhea Interventions

To reduce the number of cases of diarrhea includes:

Improved sanitation
Access to safe drinking water
Health education about how infections spread
Good personal and food hygiene

Key measures to treat diarrhea includes:

Giving more fluids than usual, including oral rehydration salts solution, to prevent dehydration
Continue feeding
Consulting a health worker if there are signs of dehydration or other problems

Diarrhea Treatment

2009-11-18T00:07:00.000-08:00

Diarrhea Treatment

Do nothing except ensure adequate fluids
Try eating more but smaller portions. Eat regularly
Don't eat or drink too quickly
Anti-diarrhea drugs
Antibiotics
Intravenous fluids or a "drip"
Dietary manipulation, especially avoid wheat products with celiac disease
Hygiene and sometime isolation
It is claimed that some fruit, such as bananas, mangoes, papaya and pineapple may have positive effects on this condition

You can remove your symptoms by the following steps below

Drink fluids
Rehydration drinks
Eat as soon as you can
Anti-diarrhea medicines
Continue breastfeeding or bottle-feeding
Painkillers

Diarrhea Diagnosis and Complications

2009-11-18T00:04:00.000-08:00

Diarrhea Diagnosis

If you have acute diarrhea, the symptoms are likely to settle down within a week and tests are usually unnecessary
If diarrhea becomes more persistent or if you have other symptoms (such as blood in your stools or dehydration) your may ask for a stool sample to investigate for bacteria
Other tests for chronic diarrhea may include blood tests or a sigmoidoscopy (a procedure that involves passing a thin fiber-optic tube, attached to a viewing lens, through the rectum to view the intestine).

Diarrhea Complications

Complications are uncommon, if you or your children have the following symptoms:

Blood in your stools
Dehydration (signs in children include passing little urine, a dry mouth and tongue, unresponsiveness, glazed eyes, drowsiness and confusion)
Diarrhea that does not clear up after five days
Vomiting that continues for more than a day
Infection that was caught while traveling abroad

Diarrhea Causes

2009-11-18T00:02:00.000-08:00

Diarrhea Causes

Diarrhea occurs when fluid cannot be absorbed from your bowel contents, or when extra fluid is concealed into the bowel, causing watery stools.
There are many causes of diarrhea, including food poisoning, infection, and malnutrition. Diarrhea may also be caused due to a chronic problem like viral stomach flu. Diarrhea occurs when the inside layer of the small or large intestine is irritated. It leads to increased water being passed in the stools

The main causes of diarrhea are listed below

Bacterial Infections, which get into our body through impure food or water.
Viral infections, including rotavirus, Norwalk virus, cytomegalovirus, herpes simplex virus, and viral hepatitis
Parasitic infections
Food Intolerance, some people are not able to digest, such as lactose, the sugar found in milk - which ultimately leads to diarrhea
Some medicines react wrong way
Functional bowel disorders
Intestinal diseases
Sometimes too much swimming also causes diarrhea

Acute (Short Term) Diarrhea
It can be caused by:

Virus, such as norovirus or rotavirus,
Food poisoning
Bacterial infection
Antibiotics
Contaminated food or water

Short-term causes of diarrhea include:

Emotional upset or nervousness
Drinking more alcohol
Drinking more coffee
Some medicines side effect

Chronic (Short Term) Diarrhea
It can be caused by:

Bacterial or viral infection
Laxatives
Poor diet

Long-term causes of diarrhea include:

Ulcerative colitis
Diabetes
Crohn's disease
Pancreatitis.
Irritable bowel syndrome
Coeliac disease,
Lactose intolerance

Diarrhea Symptoms

2009-11-17T23:52:00.000-08:00

Diarrhea Symptoms

Frequent, loose, watery stools
Fever
Headache
Loss of appetite
Abdominal pain
Nausea or Vomiting
Stomach pains
Dehydration
Pricking sensation
Loss of appetite

Diarrhea Types

2009-11-17T23:38:00.000-08:00

Diarrhea Types

Acute Watery Diarrhea (which lasts several hours or days):

The main danger is dehydration; weight loss also occurs if feeding is not continued

Acute Bloody Diarrhea (also called dysentery):

The main dangers are intestinal damage, sepsis and malnutrition; other complications, including dehydration, may also occur

Persistent Diarrhea (which lasts 14 days or longer):

The main danger is malnutrition and serious non-intestinal infection; dehydration may also occur

Diarrhea With Severe Malnutrition

The main dangers are: severe systemic infection, dehydration, heart failure and vitamin and mineral deficiency.

Diarrhea

2009-11-17T23:36:00.000-08:00

Diarrhea

Diarrhea is also called loose motions or it is the passing of watery stools more than three times a day. It is not itself a disease, but can be a symptom of several diseases. Diarrhea means there are frequent, loose or liquid stools. There may abdominal pain, which may reduce after a stool is passed.
Diarrhea can either be:

Acute Diarrhea that comes on suddenly for a short time, and lasts for five to 10 days
Chronic Diarrhea that lasts for more than two weeks or for a long period of time.

If you have diarrhea for long periods of time, it may very troubling and you may feel very weak and tired.
Diarrhea causes dehydration. Children are more likely than adults to die from diarrhea because they become dehydrated more quickly. It is also a major cause of child malnutrition.
You may recover complete from diarrhea within three to seven days. One out of every ten people with cancer may suffer from diarrhea at some time during their illness. If the diarrhea lasts more than three weeks, it is considered chronic.

Why is Diarrhea Dangerous?

Diarrhea causes rapid reduction of water and sodium - both of which are necessary for life. If the water and salts are not replaced fast, the body starts to "dry up" or get dehydrated. If more than 10% of the body's fluid is lost death occurs.

Ulcerative Colitis Treatment

2009-11-11T00:23:00.000-08:00

Ulcerative Colitis Treatment

Treatment for ulcerative colitis should:

control inflammation
correct nutritional deficiencies
reduce abdominal pain, diarrhea, and rectal bleeding

Treatment may include nutrition supplements, drugs, hospitalization, surgery, or a combination of these.

Nutritional treatment.
If symptoms are produced by certain foods, they may be controlled by avoiding foods that upset the intestines, such as seasoned foods or milk sugar called lactose.

Medications.
Different types of medications may be used to treat ulcerative colitis. These include aminosalicylates, corticosteroids and immunomodulators.

Aminosalicylates help to control inflammation. People with mild or moderate ulcerative colitis are usually treated with this type of drug first. Aminosalicylates also help if a person has a relapse.

Corticosteroids also reduce inflammation. They are often prescribed for people with moderate to severe ulcerative colitis or those who don’t find relief with aminosalicylates. Corticosteroids can cause side effects including weight gain, hypertension, diabetes, acne, facial hair, mood swings, bone mass loss and an increased risk of infection. Because of the side effects, it’s not recommended to use them long-term, but they are usually very effective for short-term use.

Immunomodulators reduce inflammation by affecting the immune system. These drugs are usually prescribed to patients who aren’t finding benefits with aminosalicylates or corticosteroids or who are dependent on corticosteroids. It can take up to 6 months before the full benefits of immunomodulators are noticed. Healthcare providers moitor patients taking immunomodulators
in case they would have complications such as pancreatitis, hepatitis, a reduced white blood cell count or an infection. Other drugs may be given to relax the patient or to relieve pain, diarrhea, or infection.

Hospitalization.
Sometimes symptoms are so severe that the person must be hospitalized. Such symptoms include severe bleeding or diarrhea causing dehydration. At the hospital, the doctor will try to stop diarrhea and blood loss, and replace lost fluids.

Surgery.
About 25-40% of ulcerative colitis patients must eventually have their colon removed due to massive bleeding, severe illness, rupture of the colon, or risk of cancer. Sometimes the doctor will recommend removing the colon if medical treatment fails, or if side effects of corticosteroids or other drugs threaten the patient's health. Some surgeries to remove the colon reroute the small intestine to the outside of the body; this is called an ileostomy. In these operations, patients lose bowel control.

Other operations take the colon out and attach the small intestine to the rectum, allowing normal bowel movements

Ulcerative Colitis Diagnosis

2009-11-11T00:22:00.000-08:00

Ulcerative Colitis Diagnosis

A thorough physical exam and a series of tests may be needed to diagnose ulcerative colitis.

Blood tests can check for low blood count, or anemia, which could indicate bleeding in the intestines. Blood tests may also uncover a high white blood cell count, which is a sign of inflammation. By testing a stool sample, the doctor can tell if there is bleeding or infection in the intestines.

The doctor may need to do a colonoscopy, which involves inserting an endoscope into the anus to see the inside of the large intestine. An endoscope is a long, flexible,lighted tube hooked to a computer and TV monitor. He or she will see any inflammation or bleeding.
During a colonoscopy, the doctor may do a biopsy, which involves taking a sample of tissue from the intestinal lining to look at under a microscope. A barium enema x-ray of the colon may also be needed. The colon is filled with barium, a chalky white solution. The barium shows up white on x-ray film, allowing the doctor a clear view of the colon.

Ulcerative Colitis Symptoms

2009-11-11T00:21:00.000-08:00

Ulcerative Colitis Symptoms

The most common symptoms of ulcerative colitis are abdominal pain and bloody diarrhea.
Patients with ulcerative colitis may also experience

fatigue
weight loss
loss of appetite
rectal bleeding
loss of body fluids and nutrients

Ulcerative Colitis Causes

2009-11-11T00:18:00.000-08:00

Ulcerative Colitis Causes

The cause of ulcerative colitis is still unknown. Doctors think that the immune system reacts to a virus or a bacterium by causing the intestinal wall to become inflamed.The immune system is made of blood cells and chemicals that find bacteria and viruses in the body and destroy them. When the immune system fights against the intestines, it can lead to inflammation, swelling, destruction, and scarring.
Ulcerative colitis usually occurs between the ages of 15-40, although children and older people can also develop it. Ulcerative colitis affects men and women equally and appears to run in some families.

Ulcerative Colitis

2009-11-11T00:17:00.000-08:00

Ulcerative Colitis

Inflammation is the body's natural way of clearing up damaged tissue. Ulcerative colitis is when the inner layers of the large intestine lining become inflamed.Ulcerative colitis causes swelling and scarring in the tissues of the colon. It may also be called colitis or proctitis.
Ulcers form in places where the inflammation has killed cells in the lining of the colon. The ulcers bleed and produce pus and mucus.
Inflammation due to ulcerative colitis usually occurs in the lower colon and the rectum, but it may affect the whole colon. Ulcerative colitis does not usually affect the small intestine.The main difference between ulcerative colitis and Crohn's disease is the location of the inflammation. Ulcerative colitis usually only affects the colon, whereas Crohn’s disease may affect the whole gastrointestinal tract.
Some people with ulcerative colitis go for long periods, even years, with no symptoms.However, the disease usually comes and goes throughout life.The inflammation causes the colon to be empty most of the time, triggering diarrhea and blood in the stool.

Anatomy

2009-11-11T00:06:00.000-08:00

Anatomy

Swallowed food goes through the esophagus,which is the feeding tube.Next, food enters the stomach, where it is digested.
Digested food travels from the stomach to the small intestines, where most nutrients are further digested and absorbed into the body.
Fibers and digested food finally reach the colon. In the colon, the rest of the nutrients get absorbed and stools are formed. Stools are stored in the last part of the colon, the sigmoid and rectum, before being excreted.The colon has several sections:

The walls of the intestines have 3 layers. The inside layer is called mucosa; it is responsible for digesting and absorbing food. The middle layer of the intestines is muscle that helps push food through. The outer layer of the intestines is called serosa. The serosa is very smooth, so the intestines do not get stuck together in the abdominal cavity.

Typhoid Fever Care

2009-11-08T05:42:00.001-08:00

Medical Care

Typhoid fever is treated with antibiotics which kill the Salmonella bacteria. Prior to the use of antibiotics, the fatality rate was 20%.
If a patient presents with unexplained symptoms described above within 60 days of returning from a typhoid fever (enteric fever) endemic area or following consumption of food prepared by an individual who is known to carry typhoid, broad-spectrum empiric antibiotics should be started immediately. Treatment should not be delayed for confirmatory tests since prompt treatment drastically reduces the risk of complications and fatalities. Antibiotic therapy should be narrowed once more information is available. With appropriate antibiotic therapy, there is usually improvement within one to two days and recovery within seven to 10 days.
Compliant patients with uncomplicated disease may be treated on an outpatient basis. They must be advised to use strict hand washing techniques and to avoid preparing food for others during the illness course. Hospitalized patients should be placed in contact isolation during the acute phase of the infection. Faeces and urine must be disposed of safely.

Surgical Care

Surgery is usually indicated in cases of intestinal perforation. Most surgeons prefer simple closure of the perforation with drainage of the peritoneum. Small-bowel resection is indicated for patients with multiple perforations.
If antibiotic treatment fails to eradicate the hepatobiliary carriage, the gallbladder should be resected. Cholecystectomy is not always successful in eradicating the carrier state because of persisting hepatic infection.
Diet Fluids and electrolytes should be monitored and replaced diligently. Oral nutrition with a soft digestible diet is preferable in the absence of abdominal distension or ileus… The carrier state, which occurs in 3%-5% of those infected, can be treated with prolonged antibiotics. Often, removal of the gallbladder, the site of chronic infection, will cure the carrier state.
For those traveling to high-risk areas, vaccines are now available

Typhoid Fever Treatment

2009-11-08T05:39:00.002-08:00

Typhoid Fever Treatment

If you are being treated for typhoid fever, it is important to do the following:
Keep taking the prescribed antibiotics for as long as the doctor has asked you to take them.
Wash your hands carefully with soap and water after using the bathroom, and do not prepare or serve food for other people. This will lower the chance that you will pass the infection on to someone else

General measures: bed rest, anti-pyretics, cold compress.
Drug therapy:
Chloramphenicole: was the first standard anti-biotic for T.F. (1948-1970), when resistant strains increased, dose: 500 mg/6 hr/ 10 d. orally.
1970: anti-biotic of choice for T.F:
Amoxicillin (750 mg/6 hr /10 d). Or
Ampicillin (1 gm /6 hr/10 d). Or
TMP-SMX (160mg TMP-800mg SMX)tab/12 hr/10d).
1989: appearance of MDR S. Typhi (multi drug resistant): anti-biotic of choice became:
Quinolones: ciprofloxacine, orally, (500mg/BD/14d), IV inf. 200mg/ BD.
Ofloxacine (10mg/kg/BD/2-3d).
3rd generation cephalosporines: ceftriaxone (1-2 gm IV, IM inj /OD/ 10-14 days).
Azithromycine: 1gm orally at day 1, then 500 mg OD, for 5 days.
Temperature may remain elevated for several days (up to 5 days) after starting anti-biotic, and this alone does not mean failure of treatment.
Even with effective anti-biotic, there is still risk of relapse or development of a chronic carrier state.
In severe complicated T.F. there is evidence about the benefit of using dexamethasone ( IV inj. 3mg/kg start then 1mg/kg for 8 doses every 6 hr) mortality decreased with this regimen from 56% to 10%.
Prolonged anti-biotic course (e.g. ciprofluxacine 500mg/ BD/ 6-8weeks) might eliminate the carrier state
But in patients with anatomical abnormalities (e.g. gall stones) the medical eradication usually not successful, and a surgical solution (e.g. cholecystectomy) should be taken into consideration

Typhoid Fever at a Glance

2009-11-08T05:39:00.001-08:00

Typhoid Fever at a Glance

Typhoid fever is caused by Salmonellae typhi bacteria. Typhoid fever is contracted by the ingestion of contaminated food or water. Diagnosis of typhoid fever is made when the Salmonella bacteria is detected with a stool culture. Typhoid fever is treated with antibiotics. Typhoid fever symptoms are poor appetite, headaches, generalized aches and pains, fever, and lethargy. Approximately 3%-5% of patients become carriers of the bacteria after the acute illness.

Typhoid Fever Investigations

2009-11-08T05:36:00.000-08:00

Typhoid Fever Investigations

Typhican be isolated from the blood early in the disease. Isolation from urine and stool is possible after the first week of illness. Bone marrow culture is the best confirmation method. Additionally, pulsed-field gel electrophoresis (PFGE) can be useful for characterizing S. Typhiisolates and establishing links between individual cases. A serological testing method, called the Vi antibody test, is available for identification of typhoid fever carriers. The presence of elevated antibody titers to a S. Typhiantigen (purified Vi polysaccharide) is highly suggestive of a chronic carrier state

Blood culture: is the gold standard for diagnosis in the 1st week (90% positive). It drops to 50% during 3rd week of infection.
Stool culture: usually negative during 1st week of infection, becomes highly positive during 2nd & 3rd week. The disadvantage is that, it does not distinguish between acutely infected patient and a chronic carrier.
Urine culture: less frequent, less sensitive.
Culture of G.I. secretion: using duodenal string test.
Culture of rose spots: positive in two thirds of patients remains positive even after receiving antibiotics.
Bone marrow culture: highly sensitive, remain positive even after 5 days of antibiotic use. Rarely required due to its invasive nature, except in patient highly suspicious of T.F. who has received antibiotic and his blood culture is negative.
WIDAL test: is a serological test that detects Ab against S.typhi somatic Ag (anti-O), or flagellar Ag (H).
It is unreliable, nonspecific, and insensitive, with high false positive results due to cross-reaction with many other types of salmonella.
Widal test is considered positive, if anti-O titer >1:320 (other references >1:80) or anti-H titer >1: 640. or if there is four fold rise of titer between acute infection and convalescent period.

Additional lab findings:
Hb : variable anemia. Platelets: often diminished.
WBC: typically leucopenia with nuetropenia (15-25%), but can be normal, or leucocytsis with lymphocytosis in little children or secondary infection or complication occur (such as intestinal perforation).
LFT: abnormal results with elevated AST, ALT and Alk.Ph.
ECG: prolonged PR interval, nonspecific ST, T wave changes.

New diagnostic methods:
Polymerase chain reaction PCR, and DNA probe test, that detect S. typhi DNA, they are highly sensitive and specific, but not widely used.

Typhoid Fever Clinical Picture

2009-11-08T05:34:00.000-08:00

Typhoid Fever Clinical Picture

Majority of patients recover without complications by receiving adequate antibiotics without delay.
1-5% of cases become asymptomatic chronic carriers, shedding S.typhi in stool and less frequently in urine.
In those carriers, S.typhi resides in gallbladder especially if associated with gallstones or Ca.gallbladder, because anatomical abnormalities allow for prolonged colonization of the organism.
In areas where schistosoma hematobium is prevalent, chronic carriage of S.typhi in urinary bladder is common.

1st Week of Typhoid Fever

Fever (>70%) is slow rising, increasing progressively in step ladder fashion over 4-5 days (38,8-40,5 c), with relative bradycardia.
Non-specific constitutional symptoms: headache, fatigue, malaria, cough, sore throat.
G.I. symptoms: abdominal pain (20-40%), constipation, diarrhea.
Early signs: relative bradycardia, abd. Tenderness (diffuse or localized, usually right lower quadrant).

2nd Week of Typhoid Fever

Abd.distension & tenderness.
Hepato-splenomegaly.
Rose-spots: maculopapular rash, 2-3 mm, in the trunk (chest & upper abdomen), fade on pressure, remains 4-5 days, disappear without scars, occur in 30% of cases, difficult to notice in dark-skinned patients.

3rd and 4th Week of Typhoid Fever

Patient is profoundly ill, complications appear.
Disturbance in consciousness, neuro-psychiatric symptoms (picking bed clothes or imaginary objects), called muttering delirium, coma vigil, typhoid psychosis.
Intestinal perforation or bleeding: shock state, fever disappears, fresh or dark bloody stool.
Cholecystitis, hepatitis, pneumonia, carditis, meningitis, nephritis, arthritis, osteomylitis…etc.
Death.

Pathogenesis of Typhoid Fever

2009-11-08T05:33:00.000-08:00

Pathogenesis of Typhoid Fever

> 100,000 organisms are required to survive the gastric acid defensive barrier. (Less number is required in persons with hypochlorhydria, using antacid or PPI)
After ingestion of contaminated food or water, S. Typhi penetrate the epithelium of small intestines, invading and replicating inside the peyrs patches, spreading after that to mesenteric L.N. and reaching systemic circulation via thoracic duct, they grow intracellularly inside the phagocytes of the reticuloendothelial system in liver, spleen and bone marrow. Spreading too many other organs
For better understanding of the molecular pathogenesis of typhoid fever, genomic and proteomic studies will reveal the possibility of new targets for diagnosis and treatment.
But the importance of safe water, sanitation, and immunisation of people at risk remains paramount
Salmonellae are important gram-negative bacilli that cause a spectrum of characteristic clinical syndromes including gastroenteritis, enteric fever, bacteremia, endovascular infections, and focal infections such as osteomyelitis or abscesses.
Enteritis fever, also called typhoid fever or paratyphoid fever, is a systemic febrile illness that is most commonly caused by Salmonella typhi; less frequent causes are S. paratyphi A, S. typhi B (also known as S. schottmuelleri), and S. paratyphi C (also known as Salmonella hirschfeldii). Even "nontyphoidal" Salmonellae may cause severe illness consistent with enteric fever.
Patients with typhoid fever classically present with sustained fever, abdominal tenderness, and hepatosplenomegaly. However, the clinical manifestations of enteric fever are varied and may include diarrhea or constipation, rash (rose spots), and neuropsychiatric symptoms. Late complications are more common in untreated individuals and include intestinal hemorrhage and perforation, or focal infection such as visceral abscesses
In the preantibiotic era, approximately 15 percent of afflicted individuals died, with survivors experiencing a prolonged illness lasting weeks and debilitation often lasting months. Approximately 10 percent of untreated individuals relapse and 1 to 4 percent become chronic carriers of the organism, testaments to the tenacity of these intracellular pathogens. Antibiotic therapy is effective, but increasing resistance of both S. typhi and S. paratyphi to standard antimicrobial agents has become a worldwide problem
The pathogenesis of typhoid fever will be reviewed here. The pathogenesis of gastroenteritis caused by nontyphoidal Salmonellae is discussed separately

How to Avoid Typhoid Fever

2009-11-08T05:32:00.000-08:00

How to Avoid Typhoid Fever
Two basic actions can protect you from typhoid fever:

Avoid risky foods and drinks.
Get vaccinated against typhoid fever.

It may surprise you, but watching what you eat and drink when you travel is as important as being vaccinated. This is because the vaccines are not completely effective. Avoiding risky foods will also help protect you from other illnesses, including travelers' diarrhea, cholera, dysentery, and hepatitis A.
If you drink water, buy it bottled or bring it to a rolling boil for 1 minute before you drink it. Bottled carbonated water is safer than un-carbonated water.
Ask for drinks without ice unless the ice is made from bottled or boiled water. Avoid popsicles and flavored ices that may have been made with contaminated water.
Eat foods that have been thoroughly cooked and that are still hot and steaming.
Avoid raw vegetables and fruits that cannot be peeled. Vegetables like lettuce are easily contaminated and are very hard to wash well.
When you eat raw fruit or vegetables that can be peeled, peel them yourself. (Wash your hands with soap first.) Do not eat the peelings.
Avoid foods and beverages from street vendors. It is difficult for food to be kept clean on the street, and many travelers get sick from food bought from street vendors.

Typhoid Fever Vaccination

2009-11-08T05:16:00.000-08:00

Typhoid Fever Vaccination

Two parenteral (inactivated, killed), one oral (live attenuated). No life-long protection.
Traveling to endemic area.
Household contact with infected patient or carrier.
Lab worker with contact to S. typhi specimen.
Epidemic outbreak.

Vaccine	Age	Route	Dosage	Re-vaccination
Killed whole-cell vaccine	5 Years	Subcutaneous	0.5 ml (0.25 ml for Children less than 10y) ‏x 2 times, 4 weeks apart	3 Years
Vi CPS	2 Years	Subcutaneous	0.5 ml	3 Years
Ty21 a, live	6 Years	Oral	1 capsule every other day, total of 3 capsule	5 Years

1st parenteral has many side-effects. Given in 2 injections 4weeks apart, with booster dose every 3-5 years.
2nd parenteral (viCPS): less S.E. 1 inj. Booster dose every 2 years.
Oral (ty21a): the safest, 1 dose, alternate day for atotal of 4doses, then booster dose every 5 years(C/I in children <6y,>

Typhoid Fever Antibiotics
For uncomplicated cases, use Conventional Therapy:

Chloramphenicol 3-4 gm per day PO in 4 divided doses x 14 days (50-100 mg/kg BW) except it with low WBC
Co-trimoxazole forte or double-strength tab BID PO x 14 days
Amoxicillin 4-6 gm per day PO in 3 divided doses x 14 days

Getting Vaccinated

If you are traveling to a country where typhoid is common, you should consider being vaccinated against typhoid. Visit a doctor or travel clinic to discuss your vaccination options.
Remember that you will need to complete your vaccination at least 1 week before you travel so that the vaccine has time to take effect. Typhoid vaccines lose effectiveness after several years; if you were vaccinated in the past, check with your doctor to see if it is time for a booster vaccination.
Taking antibiotics will not prevent typhoid fever; they only help treat it.
Typhoid fever's danger doesn't end when symptoms disappear. Even if your symptoms seem to go away, you may still be carrying S. Typhi. If so, the illness could return, or you could pass the disease to other people. In fact, if you work at a job where you handle food or care for small children, you may be barred legally from going back to work until a doctor has determined that you no longer carry any typhoid bacteria.

Typhoid Fever Prevention

2009-11-08T05:13:00.001-08:00

Typhoid Fever Prevention

Choose foods processed for safety
Prepare food carefully
Foods prepared by others (avoid if possible)‏
Keep food contact surfaces clean
Eat cooked food as soon as possible
Maintain clean hands
Steam or boil shellfish at least 10 minutes
All milk and dairy products should be pasteurized
Control fly populations
Improved sanitation and health education.
Checking food-handlers by periodic stool culture.

Typhoid Fever Diagnosis

2009-11-08T04:28:00.000-08:00

Diagnosis of Typhoid Fever:

CBC (normal WBC despite fever), platelet count
Tourniquet Test
Typhi dot test (if illness is 4 days or longer)
Malarial smear (Differential diagnosis)‏
Chest X-ray
Urinalysis
First Week of illness: Blood C/S
Second Week of illness: Urine G/S, C/S
Third Week of illness: Stool C/S

Typhoid Fever Symptoms

2009-11-08T04:27:00.001-08:00

Typhoid Fever Symptoms

The incubation period is usually one to two weeks, and the duration of the illness is about four to six weeks. The patient experiences poor hunger, headaches, generalized aches and pains, fever, tiredness, and diarrhea. Patients with typhoid fever usually have a sustained fever as high as 103 to 104 degrees Fahrenheit (39 to 40 degrees Celsius).
• Diarrhea may occur
• Active infection
• Severe Headache
• Abdominal Pain
• Anorexia
• Fever [usually higher in the evening]
- Intermittent Fever initially
- Sustained Fever to high temperatures later
Chest congestion develops in many patients, and abdominal pain and discomfort are common. The fever becomes constant. Improvement occurs in the third and fourth week in those without complications.
About 10% of patients have recurrent symptoms (decline) after feeling better for one to two weeks.

How Bacteria Cause Typhoid Fever

2009-11-08T04:22:00.000-08:00

How Bacteria Cause Typhoid Fever

After the eating or drinking of infected food or water, the Salmonella bacteria invade the small intestine and enter the bloodstream temporarily. The bacteria are carried by white blood cells in the liver, irritation, and bone marrow. The bacteria then multiply in the cells of these organs and reenter the bloodstream. Patients develop symptoms, including fever, when the organism reenters the bloodstream. Bacteria attack the gallbladder, bleary system, and the lymphatic tissue of the bowel. Here, they multiply in high numbers. The bacteria pass into the intestinal tract and can be identified for diagnosis in cultures from the stool tested in the laboratory

How Patients Get Typhoid Fever

2009-11-08T04:18:00.000-08:00

How Patients Get Typhoid Fever

Typhoid fever is contracted by the intake of the bacteria in infected food or water. Patients with acute illness can infect the surrounding water supply through stool, which contains a high concentration of the bacteria. Infectious of the water supply can, in turn, infect the food supply. About 3%-5% of patients become carriers of the bacteria after the acute illness. Some patients suffer a very mild illness that goes unrecognized. These patients can become long-term carriers of the bacteria. S typhi has no nonhuman vectors. The following are modes of transmission: Oral transmission via food or beverages handled by an individual who chronically discard the bacteria through stool or, less commonly urine, Hand-to-mouth transmission after using a contaminated toilet and neglecting hand hygiene Oral transmission via sewage-contaminated water or shellfish (especially in the developing world)
The bacteria multiply in the gallbladder, bile ducts, or liver and passes into the bowel. The bacteria can survive for weeks in water or dried sewage. These chronic carriers may have no symptoms and can be the source of new outbreaks of typhoid fever for many years.

Typhoid Fever Incidence

2009-11-08T04:17:00.000-08:00

Typhoid Fever Incidence

Typhoid fever is more common in areas of the world where hand washing is less frequent and water is likely to be contaminated with sewerage. Typhoid fever is common in most parts of the world except in industrialized regions such as the United States, Canada, Western Europe, Australia, and Japan. Therefore, if you are traveling to the developing world, you should consider taking safety measures. Over the past 10 years, travelers from the United States to Asia, Africa, and Latin America have been especially at risk. The incidence of typhoid fever in the United States has markedly decreased since the early 1900s. Mexico and South America are the most common areas to contract typhoid fever. India, Pakistan, and Egypt are also known high-risk areas for developing this disease.
Worldwide, typhoid fever affects more than 16 million people annually, with over 600,000 patients dying of the disease.
Most documented typhoid fever cases involve school-aged children and young adults.

Typhoid Fever

2009-11-08T04:13:00.000-08:00

Typhoid Fever

Typhoid fever is an acute systemic illness characterized by fever, headache and abdominal discomfort.
It is caused by salmonella typhi (gram-ve bacilli). Family of enterobacteriacea
A similar but less severe illness known as paratyphoid fever, caused by salmonella paratyphi (A, B, C)
Typhoid fever, also known as enteric fever, is a potentially fatal multi systemic illness.
Typhoid fever is an acute illness associated with fever caused by the Salmonella typhi bacteria. It can also be caused by Salmonella paratyphi, a related bacterium that usually causes a less severe illness.
Eating or drinking of contaminated food or water; rarely from person to person transmission through faecal-oral route
S typhi has been a major human pathogen for thousands of years, prosperous in conditions of poor hygiene, crowding, and social confusion. It may have responsible for the big disease of Athens at the end of the Peloponnesian War.
The name S typhi is derived from the ancient Greek typhos, an ethereal smoke or cloud that was believed to cause disease and madness. In the advanced stages of typhoid fever, the patient's level of consciousness is truly clouded. Although antibiotics have markedly reduced the frequency of typhoid fever in the developed world, it remains endemic in developing countries.
Once S. Typhi bacteria are eaten or drunk, they multiply and spread into the bloodstream. The body reacts with fever and other signs and symptoms.

Types of Typhoid Fever

* Paratyphoid fever
* Brion-Kayser disease
* Schottmuller's disease

Cancer Cases

2009-09-06T20:07:00.000-07:00

Types Of Cancer Cases

Cancer Type	Estimated New Cases	Estimated Deaths
Bladder	70,980	14,330
Breast(Female-Male)	192,370-1,910	40,170-440
Colon and Rectal(Combined)	146,970	49,920
Endometrial	42,160	7,780
Kidney(Renal Cell)Cancer	49,096	11,033
Leukemia(All)	44,790	21,870
Lung(Including Bronchus)	219,440	159,390
Melanoma	68,720	8,650
Non-Hodgkin Lymphoma	65,890	19,500
Pancreatic	42,470	35,240
Prostate	192,280	27,360
Skin (Nonmelanoma)	>1,000,000	<1,000
Thyroid	37,200	1,630

Region Wise Cases Ratio

North America
Incident Cases	15,70,500
Prostate	16%
Breast	15%
Lung	14%
Colon And Rectum	12%
The Caribbean
Incident Cases	66,500
Prostate	14%
Breast	10%
Lung	10%
Cervix	10%
Central America
Incident Cases	153,600
Prostate	8%
Breast	9%
Stomach	8%
Cervix	11%
South America
Incident Cases	612,900
Prostate	10%
Breast	12%
Stomach	9%
Cervix	8%
Western Europe
Incident Cases	873,700
Prostate	11%
Breast	14%
Lung	11%
Colon And Rectum	14%
Northern Europe
Incident Cases	426,400
Prostate	11%
Breast	15%
Lung	13%
Colon And Rectum	13%
Eastern Europe
Incident Cases	903,400
Stomach	10%
Breast	11%
Lung	16%
Colon And Rectum	12%
Southern Europe
Incident Cases	617,300
Prostate	8%
Breast	12%
Lung	13%
Colon And Rectum	13%
Northern Africa
Incident Cases	119,600
Bladder	12%
Breast	14%
Lung	7%
Cervix	7%
Western Africa
Incident Cases	140,400
Prostate	7%
Breast	15%
Liver	11%
Cervix	15%
Middle Africa
Incident Cases	78,100
Stomach	9%
Kaposi Sarcoma	17%
Liver	16%
Cervix	11%
Southern Africa
Incident Cases	63,800
Prostate	7%
Kaposi Sarcoma	7%
Breast	10%
Cervix	12%
Eastern Africa
Incident Cases	247,900
Oesophagus	7%
Kaposi Sarcoma	14%
Liver	8%
Cervix	14%
Western Asia
Incident Cases	200,200
Lung	13%
Breast	13%
Stomach	6%
Colon And Rectum	7%
South Central Asia
Incident Cases	1,261,500
Crevix	13%
Breast	11%
Oral Cavity	9%
Lung	6%
Eastern Asia
Incident Cases	2,890,300
Lung	17%
Stomach	19%
Liver	14%
Oesophagus	9%
South Eastern Asia
Incident Cases	524,900
Lung	13%
Breast	11%
Liver	9%
Colon And Rectum	9%
Australia / New Zealand
Incident Cases	103,700
Prostate	13%
Breast	13%
Melonoma of Skin	10%
Colon And Rectum	14%

Rate Per 100,000 Population
Northern America	330.6
Australia/New Zealand	299.1
Western Europe	266.7
Northern Europe	252.5
Southern Europe	237.2
Eastern Europe	195.9
South America	193.6
Southern Africa	174.2
Caribbean	171.6
Eastern Asia	169.0
Eastern Africa	151.7
Central America	143.9
Western Asia	130.2
Middle Africa	125.3
South Eastern Asia	119.1
South Central Asia	101.9
Western Africa	92.9
Northern Africa	87.2

Swine Flu Cases

2009-08-20T23:44:00.000-07:00

Swine Flu (H1N1) Cases

These Cases Are Updated Till Now
Country	Confirmed Cases	Death Cases
USA	43,771	556
Canada	10,156	72
Mexico	20,860	193
Guatemala	720	12
EI Salvador	726	17
Honduras	363	8
Costa Rica	1,058	33
Panama	647	7
Cook Island	1	1
French Polynesia	16	3
Bermuda	4	0
Bahamas	23	0
Cuba	306	0
Jamaica	80	4
Haiti	5	0
Dominician Republic	182	8
Cayman Islands	60	1
Aruba	13	0
Antilles Curacao	46	1
British Virgin Islands	5	0
St Marteen	22	0
St Kitts & Nevis	6	1
Antigua & Barbuda	3	0
Guadaloupe	11	0
Dominica	1	0
Martinique	44	0
Barbados	60	0
St Lucia	13	0
St Vincent & Grenadines	2	0
Grenada	3	0
Trinidad & Tobago	97	0
Venezuela	783	24
Colombia	621	35
Ecuador	1,382	40
Guyana	7	0
Suriname	11	0
Peru	6,608	98
Bolivia	1,389	19
Brazil	5,206	557
Paraguay	472	41
Chile	12,194	130
Uruguay	550	32
Argentina	7,173	465
UK	13,095	66
Isle of Man	29	0
Ireland	767	2
Channel Islands	17	0
Iceland	165	0
Norway	1,025	1
Sweden	915	1
Finland	214	0
Denmark	558	0
Germany	16,116	0
Belgium	126	1
France	1,125	2
Switzerland	1,041	0
Austria	314	0
Czech Republic	258	0
Estonia	61	0
Latvia	27	0
Lithuania	48	0
Russia	55	0
Poland	157	0
Slovakia	121	0
Hungary	151	1
Slovenia	217	0
Croatia	61	0
Monaco	1	0
Andorra	1	0
Spain	1,538	21
Portugal	2,244	0
Italy	1,800	0
Malta	277	1
Bosnia & Herzegovania	10	0
Montenegro	18	0
Serbia	120	0
Romania	305	0
Moldova	2	0
Ukraine	1	0
Kosovo	1	0
Bulgaria	64	0
Macedonia	27	0
Albania	13	0
Greece	1,839	1
Malta	150	0
Turkey	199	0
Georgia	12	0
Cape Verde	37	0
Morocco	135	0
Algeria	33	0
Tunisia	39	0
Libya	19	0
Egypt	703	1
Sudan	2	0
Ethiopia	4	0
Kenya	85	0
Uganda	11	0
Tanzania	8	0
Swaziland	2	0
South Africa	5,118	27
Botswana	23	0
Namibia	38	0
Gabon	1	0
Inory Caost	2	0
Cyprus	297	0
Isreal	1,719	16
Saudia Arabia	595	19
Yemen	22	1
Oman	763	10
UAE	79	2
Qatar	23	1
Bahrain	83	1
Kuwait	1,424	5
Iraq	166	1
Syria	25	2
Azerbaijan	2	0
Iran	285	2
Kazakhstan	15	0
Afghanistan	32	0
Mauritius	69	7
Seychelles	3	0
Maldives	2	0
Sri Lanka	78	0
India	2,909	101
Pakistan	2	0
Nepal	28	0
Bhutan	6	0
Bangladesh	117	0
China	8,406	14
South Korea	2,032	4
Japan	5,022	3
Taiwan	1,280	0
Thailand	13,019	130
Burma	9	0
Cambodia	21	0
Vietnam	995	2
Malaysia	1,476	72
Singapore	1,217	16
Indonesia	1,005	8
Brunei Darussalam	786	1
Philppines	3,207	8
Palau	1	0
Micronesia	1	0
Papua New Guinea	1	0
Solomon Islands	3	0
Vanuatu	3	0
New Caledonia	112	5
Fiji	97	0
Samoa	37	2
Tonga	9	1
New Zealand	3,143	17
Australia	35,225	160
Belize	23	0
Cameron	4	0
Cote d'Ivoire	2	0
Democratic Republic of Congo	1	0
Reunion-Mayotte	26	0
Ghana	8	1
Jordan	152	0
Laos	156	1
Lebanon	352	1
Liechtenstein	5	0
Luxembourg	144	0
Madagascar	6	0
The Marshall Islands	1	1
Mozambique	1	0
Myanmar	25	0
Nauru	1	0
Netherlands	1,473	2
Antilles Bonaire	29	0
Nicaragua	840	4
Occupied Palestinian Territories	123	1
Tanzania	53	0
Timor Leste	2	0
Falklands	7	0
Gibraltar	3	0
Guernsey	17	0
Jersey	102	0
Turks and Caicos Islands	32	0
Puerto Rico	20	0
Virgin Island	49	0
Zambia	5	0
Antilles-Guyane	9	0
French Guiana	12	0
Guadeloupe	6	0
Saint Martin	15	0
Sovereign Base Area Cyprus	44	0
Dijbouti	7	0
Lesotho	4	0
American Samoa	8	0
Zimbabwe	5	0
Total Cases	232,255	3,014

Swine Flu Preventing, Treatment, Spread, Vaccines

2009-08-20T22:11:00.000-07:00

Swine Flu (H1N1) Spread
The new swine flu virus apparently spreads just like regular flu. You could pick up germs directly from droplets from the cough or sneeze of an infected person, or by touching an object they recently touched, and then touching your eyes, mouth, or nose, delivering their germs for your own infection. That's why you should make washing your hands a habit, even when you're not ill. The new swine flu virus is a human virus spread by people and not by pigs. The only way to get the new swine flu is from another person.

Swine Flu (H1N1) Self-Care at Home
People who are suspected of having swine influenza should stay home from work and not go into the community until the infectious period are over. The infectious period is seven days after the beginning of symptoms or 24 hours after symptoms resolve (whichever is longer). If it is crucial for an ill person to leave home, he or she should wear a surgical mask to reduce the risk of spreading the disease

Swine Flu (H1N1) Treatment
Swine influenza strain is sensitive to two antiviral medicines that are used to treat human influenza. They are oseltamivir (Tamiflu) and zanamivir (Relenza). Oseltamivir is given in pill form. Zanimivir is an inhaled medication. Older drugs like amantadine are not effective.

Swine Flu (H1N1) Treated
Pandemic swine flu virus is sensitive to the antiviral drugs Tamiflu and Relenza. The CDC recommends those drugs to prevent or treat swine flu; the drugs are most effective when taken within 48 hours of the start of flu symptoms. But not everyone needs those drugs. Most people
who have come down with swine flu have recovered without treatment.

Swine Flu (H1N1) Preventing
The CDC recommends taking these steps:
• Wash your hands regularly with soap and water, especially after coughing or sneezing. Or use an alcohol-based hand cleaner if soap and water are not available.
• Avoid close contact -- that is, being within 6 feet -- with people who have flu-like symptoms.
• Avoid touching your mouth, nose, or eyes. That's not easy to do, so keep those hands clean.
• If you have flu-like symptoms -- fever plus at least cough or sore throat or other flu symptoms -- stay home for seven days after symptoms begin or until you've been symptom-free for 24 hours -- whichever is longer.
• Wear a face mask (consider using an N95 respirator) if you must come into close contact with a sick person. "Close contact" means within 6 feet. Note: There is no definitive proof that a face mask prevents flu transmission. Do not rely solely on a face mask to prevent infection.
• Wear an N95 respirator if helping a sick person with a nebulizer, inhaler, or other respiratory treatment. Note: There is no definitive proof that a respirator prevents flu transmission. Do not rely solely on a respirator to prevent infection.
• People who have or are suspected of having swine flu should wear a face mask, if available and tolerable, when sharing common spaces with other household members, when outside the home, or when near children or infants.
• Breastfeeding mothers with swine flu symptoms should express their breast milk, and the child should be fed by someone else.

Swine Flu (H1N1) Treated
Pandemic swine flu virus is sensitive to the antiviral drugs Tamiflu and Relenza. The CDC recommends those drugs to prevent or treat swine flu; the drugs are most effective when taken within 48 hours of the start of flu symptoms. But not everyone needs those drugs. Most people
who have come down with swine flu have recovered without treatment.

Swine Flu (H1N1) Preventing
The CDC recommends taking these steps:
• Wash your hands regularly with soap and water, especially after coughing or sneezing. Or use an alcohol-based hand cleaner if soap and water are not available.
• Avoid close contact -- that is, being within 6 feet -- with people who have flu-like symptoms.
• Avoid touching your mouth, nose, or eyes. That's not easy to do, so keep those hands clean.
• If you have flu-like symptoms -- fever plus at least cough or sore throat or other flu symptoms -- stay home for seven days after symptoms begin or until you've been symptom-free for 24 hours -- whichever is longer.
• Wear a face mask (consider using an N95 respirator) if you must come into close contact with a sick person. "Close contact" means within 6 feet. Note: There is no definitive proof that a face mask prevents flu transmission. Do not rely solely on a face mask to prevent infection.
• Wear an N95 respirator if helping a sick person with a nebulizer, inhaler, or other respiratory treatment. Note: There is no definitive proof that a respirator prevents flu transmission. Do not rely solely on a respirator to prevent infection.
• People who have or are suspected of having swine flu should wear a face mask, if available and tolerable, when sharing common spaces with other household members, when outside the home, or when near children or infants.
• Breastfeeding mothers with swine flu symptoms should express their breast milk, and the child should be fed by someone else.

Swine Flu (H1N1) Vaccines
There is no vaccine currently available for the swine influenza virus. However, the CDC and World Health Organization are already working on a specific vaccine which could be available in the next few months

Swine Flu Symptoms And Risk

2009-08-20T22:02:00.000-07:00

Swine Flu (H1N1) Overview
The Swine Flu is a respiratory viral disease which is usually found in pigs but can sometimes be transmitted to humans and cause outbreak or deadly disease. The viral strain involved is type A H1N1. The virus can be spread amongst humans from direct contact which can occur through coughing, sneezing or infectivity of hands and surfaces.
Pigs can get influenza (flu), but swine flu viruses aren't the same as human flu viruses. Swine flu doesn't often infect people. The current "swine flu" outbreak is different. It's caused by a new swine flu virus that has changed in ways that allow it to spread from person to person, and it's happening among people who haven't had any contact with pigs.
To distinguish it both from flu viruses that infect mainly pigs and from the seasonal influenza A H1N1 viruses, the Central Depository Company (CDC) calls the virus "novel influenza A (H1N1) virus" and the World Health Organization calls it "pandemic (H1N1) 2009”. The CDC calls swine flu illness "H1N1 flu" and the World Health Organization calls it "pandemic influenza A (H1N1)."

Swine Flu (H1N1) Symptoms
Swine flu symptoms are Body aches, Cough, Chills, Fatigue, Fever, Headache, Loss of appetite, Muscle pain, Joint pain, Runny nose, Nasal congestion, Sore throat. Many people with swine flu have had diarrhea and vomiting. Nearly everyone with flu has at least two of these symptoms.

Swine Flu (H1N1) Highest Risk
Most cases of H1N1 swine flu have been in older children and young adults. It's not clear why, and it's not clear whether this will change.

• Young children, especially those under 12 months of age
• Elderly people are at higcoph risk of severe flu disease. But relatively few swine flu cases have been seen in people over age 65.
• People with cardiovascular conditions (except high blood pressure)
• People with liver problems
• Kidney problems
• People with blood disorders, including sickle cell disease
• People with neurologic disorders
• People with neuromuscular disorders
• People with metabolic disorders, including diabetes
• People with immune suppression
• Residents of a nursing home or other chronic-care facility
Swine Flu Emergency Warnings

Children should be given urgent medical attention if they:
• Have fast breathing or trouble breathing
• Have bluish or gray skin color
• Are not drinking enough fluid
• Are not waking up or not interacting
• Have severe or persistent vomiting
• Are so irritable that the child does not want to be held
• Have flu-like symptoms that improve but then return with fever and a worse cough
• Have fever with a rash
• Have a fever and then have a seizure or sudden mental or behavioral change.

Adults should seek urgent medical attention if they have:
• Difficulty breathing or shortness of breath
• Pain or pressure in the chest or abdomen
• Sudden dizziness
• Confusion
• Severe or persistent vomiting
• Flu-like symptoms that improve, but then come back with worsening fever or cough

Swine Flu Serve
The severity of cases in the current swine flu outbreak has varied widely, from mild cases to fatalities. Most cases have been mild, but there have been a number of deaths and hundreds of hospitalizations -- mostly in young people aged 5 to 24.
Like seasonal flu, children who get swine flu can have serious neurological complications such as seizures and Reye's syndrome. But as with seasonal flu, these complications fortunately are rare.
Studies of the swine flu virus show that it is more infectious to lung cells than are seasonal flu viruses. But studies also suggest that the swine flu virus is less well adapted to humans and may be harder to inhale deep into the lungs.
Flu viruses change all the time, and the way the pandemic swine flu virus evolved suggests that it is particularly liable to swap gene segments with other flu viruses. But so far the swine flu virus hasn't changed much. That's good news, as the vast majority of swine flu cases have been mild. And it's also good news for the swine flu vaccine, which is based on swine flu strains isolated early in the pandemic.
It's impossible to know whether the virus will become more deadly. Scientists are watching closely to see which way the new swine flu virus is heading -- but health experts warn that flu viruses are notoriously hard to predict.
But there's a lot of planning you can do. CDC officials predict that just about every community will have H1N1 swine flu cases. It's possible some schools in your community may temporarily close, or even that major gatherings may be canceled. So make contingency plans just in case you are affected. For more information on preparedness planning, see the U.S. government's pandemicflu.gov web site.

Asthma

2009-08-18T22:02:00.000-07:00

Asthma Overview
Asthma is a continual long-term lung disease that inflames and narrows the airways. Asthma causes recurring periods of wheezing (a whistling sound when you breathe), chest tightness, shortness of breath, and coughing. Asthma affects people of all ages, but it most often starts in childhood. Asthma is a very common disease in the United States. A third of these are children and younger people. Asthma affects all races and is slightly more common in African Americans than in other races.

Asthma Causes
The exact cause of asthma isn't known. These factors include:
• An inherited tendency to develop allergies, called atopy
• Parents who have asthma
• Certain respiratory infections during childhood
• Contact with some airborne allergens or exposure to some viral infections in infancy or in early childhood when the immune system is developing
• Exposure to tobacco or wood smoke
• Breathing polluted air
• Inhaling other respiratory irritants such as perfumes or cleaning products
• Exposure to airway irritants at the workplace
• Breathing in allergy-causing substances such as molds, dust, or animal dander
• An upper respiratory infection, such as a cold, flu, sinusitis, or bronchitis
• Exposure to cold, dry weather
• Emotional excitement or stress
• Physical exertion or exercise
• Reflux of stomach acid known as gastro esophageal reflux disease, or GERD, sulfites, an additive to some foods and wine
• In some, not all, women, asthma symptoms are closely tied to the menstrual cycle

Asthma Symptoms
• Wheezing is a whistling or squeaky sound that occurs when you breathe
• Breathlessness may feel like you can't get air out of your lungs
• Chest tightness eel like something is compress on your chest
• Coughing is often worse at night or early in the morning, making it hard to sleep
• Difficulty in speaking

What Causes Asthma Symptoms to Occur?
• Allergens found in dust, animal hair, cockroaches, mold, and pollens from trees, grasses, and flowers
• Irritants such as cigarette smoke, air pollution, chemicals or dust in the workplace, compounds in home decoration products, and sprays
• Certain medicines such as aspirin or other non-steroidal anti-inflammatory drugs
• Sulfites in foods and drinks
• Viral upper respiratory infections such as colds

Malaria

2009-08-17T21:57:00.000-07:00

Malaria Overview
It is a serious disease that causes a high fever from a bite by an infected mosquito.

Malaria Causes
• Malaria is caused by protozoan of the genus Plasmodium.
• Infection begins with a bite from an infected mosquito.
• The parasite travels from the mosquito to your liver, where the parasite begins to reproduce.
• The parasite leaves the liver and travels to the bloodstream, where it infects red blood cells. The parasite reproduces in the red blood cells, which destroys the cells and releases more parasites into the bloodstream.
• If another mosquito bites an infected person, that mosquito can then carry the infection to someone else.
• An unborn baby (fetus) may get the disease from its mother

Malaria Symptoms
• High fever, which comes and goes every other day or few days
• Flu with high fever and body aches.
• Also from headache, nausea, shaking chills (rigors), sweating, and weakness.
• It may cause more serious problems, such as damage to the heart, lungs, kidneys, or brain. It can even be deadly

Types of Malaria
• P-vivax-Most common in India and Central and South America but found worldwide. It has an incubation period of 8-13 days and can hide in the liver and return later. It develop anemia and rupture of the spleen, which can become life threatening
• P-ovale-Rarely found outside Africa. This form of malaria has an incubation period of 8-17 days and can hide in the liver of partially treated people and return later. It cause anemia, but this infection is rarely life threatening.
• P-malariae-Found worldwide but less common than the other forms. This form of malaria has an incubation of 2-4 weeks. It is rarely life threatening, but a long-standing disease can lead to kidney failure
• P-falciparum-Common worldwide. It has an incubation period of 5-12 days. The red blood cells actually break down, kidney failure, coma, and death

How Malaria Diagnosed
• Doctor will order a blood test to check for the malaria parasite in your blood.

Hepatitis

2009-08-12T23:43:00.000-07:00

Hepatitis
Hepatitis is an inflammation of the liver, most commonly caused by a viral infection.

Types of Hepatitis

Hepatitis A
It is a virus that causes acute liver disease is caused by eating food and drinking water infected with a virus called HAV. It can also be caused by anal-oral contact during sex. While it can cause swelling and inflammation in the liver, it doesn't lead to chronic, or life long, disease. Almost everyone who gets hepatitis A has a full recovery
To prevent hepatitis A, remember to:
• Wash hands after using washroom
• Eat freshly cooked foods
• Drink commercially bottled water or boiled water and do not eat fruits or vegetables unless cleaned thoroughly
• Get a hepatitis A vaccination

Hepatitis B
It is a virus that can lead to chronic liver disease is caused by the virus HBV. It is spread by contact with an infected person's blood, semen, or other body fluid. And, it is a sexually transmitted disease (STD). You can get hepatitis B by:
• Having unprotected with an infected person.
• Sharing drug needles with an infected person.
• Sharing a toothbrush, razor, or other personal items with an infected person.
• An infected woman can give hepatitis B to her baby at birth or through her breast milk.
• Through a bite from another person.
To prevent hepatitis B, remember to:
• Practice safe sex.
• Don't share needles, razors, toothbrushes, manicure tools that could bear infected blood.
• Get the hepatitis B vaccination series

Hepatitis C
It is a virus that can lead to chronic liver disease is caused by the virus HCV. It is spread the same way as hepatitis B, through contact with an infected person's blood, semen, or body fluid (see above). Like hepatitis B, hepatitis C causes swelling of the liver and can cause liver damage that can lead to cancer.
To prevent hepatitis C, remember to:
• Cover open injury
• Practice safe sex
• Don't share needles, razors, toothbrushes, manicure tools that could bear infected blood.
• Limit alcohol drinking.
• Never share drug needles or other drug equipment.

Hepatitis D
It is caused by the virus HDV. You can only get hepatitis D if you are already infected with hepatitis B. It is spread through contact with infected blood, dirty needles that have HDV on them, and unprotected sex with a person infected with HDV. Hepatitis D causes swelling of the liver.
To prevent hepatitis D:
• Hepatitis D virus cannot infect on its own without hepatitis B, use the same measures outlined in hepatitis B.

Hepatitis E
It is caused by the virus HEV. You get hepatitis E by drinking water infected with the virus. It causes swelling of the liver, but no long-term damage. It can also be spread through oral-anal contact
To prevent hepatitis E, remember to:
• Wash hands after using washroom
• Eat freshly cooked foods
• Drink commercially bottled water or boiled water and do not eat fruits or vegetables unless cleaned thoroughly

Symptoms of Hepatitis
As the condition on initial stage
• mild fever
• muscle or joint aches
• sickness
• vomiting
• loss of hunger
• slight abdominal pain
• diarrhea
• low energy
As the condition worsens
• jaundice (yellowed skin, mucous membranes and eye-whites)
• dark urine
• light colored stools that may contain pus
• itching
• enlarged spleen
• hives
• headache
• dizziness
• drowsiness
• circulation problems

HIV AIDS

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HIV AIDS Overview
Human immunodeficiency virus (HIV) is a virus that is transmitted from person to person through the exchange of body fluids such as blood, semen, breast milk and vaginal secretions. Sexual contact is the most common way to spread HIV AIDS, but it can also be transmitted by sharing needles when injecting drugs, or during childbirth and breastfeeding.
Difference Between HIV-1 and HIV-2
There are two types of HIV: HIV-1 and HIV-2. Both types are transmitted by sexual contact, through blood, and from mother to child, and they appear to cause clinically indistinguishable AIDS. However, it seems that HIV-2 is less easily transmitted, and the period between initial infection and illness is longer in the case of HIV-2.
Worldwide, the predominant virus is HIV-1, and generally when people refer to HIV without specifying the type of virus they will be referring to HIV-1. The relatively uncommon HIV-2 type is concentrated in West Africa and is rarely found elsewhere.
Subtypes of HIV-1
Each type is divided into groups, and each group is divided into subtypes and CRFs.
The strains of HIV-1 can be classified into three groups: the "major" group M, the "outlier" group O and the "new" group N. These three groups may represent three separate introductions of simian immunodeficiency virus into humans.
Group O appears to be restricted to west-central Africa and group N - discovered in 1998 in Cameroon - is extremely rare. More than 90% of HIV-1 infections belong to HIV-1 group M and, unless specified, the rest of this page will relate to HIV-1 group M only.
Within group M there are known to be at least nine genetically distinct subtypes (or clades) of HIV-1. These are subtypes A, B, C, D, F, G, H, J and K.

Cancer Symptoms

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Persistent Fatigue:
Fatigue is physical or mental exhaustion that can be triggered by stress, medication, overwork, or mental and physical illness or disease
Unintentional Weight Loss:
Weight loss is a reduction in body mass characterized by a loss of adipose tissue (body fat) and skeletal muscle
Stomach/Lower Pack/Shoulder Pain:

Lower pack pain is cancer symptom that is associated with ovarian cancer and colon cancer.
Shoulder pain can also be a symptom of lung cancer. Pain in the form of headaches can be associated with brain tumors (malignant and benign).
Stomach pains can be related to types of cancer, like stomach cancer, pancreatic cancer, and many others. Stomach pain can be a very vague symptom because so many illnesses can cause stomach pain.
Fever:
Fevers are commonly associated with types of cancer that affects the blood, like leukemia and lymphoma, but are also common in people whose cancer has spread.
Bowel Changes:
These symptoms are most commonly associated with colon cancer, but are also related to other cancer types.
Chronic Cough:
A persistent, new cough or a cough that won't go away or becomes worse. In relation to cancer, a chronic cough with blood or mucus can be symptom of lung cancer.

Cancer Types

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Anal Cancer

It forms in tissues of the anus. The anus is the opening of the rectum (last part of the large intestine) to the outside of the body.

Bladder Cancer

It forms in tissues of the bladder (the organ that stores urine).
Most bladder cancers are transitional cell carcinomas (cancer that begins in cells that normally make up the inner lining of the bladder).
Other types include squamous cell carcinoma (cancer that begins in thin, flat cells) and adenocarcinoma (cancer that begins in cells that make and release mucus and other fluids). The cells that form squamous cell carcinoma and adenocarcinoma develop in the inner lining of the bladder as a result of chronic irritation and inflammation.

Breast Cancer
It forms in tissues of the breast, usually the ducts (tubes that carry milk to the nipple) and lobules (glands that make milk). It occurs in both men and women, although male breast cancer is rare

Cervical Cancer
It forms in tissues of the cervix (the organ connecting the uterus and vagina). It is usually a slow-growing cancer that may not have symptoms but can be found with regular Pap tests (a procedure in which cells are scraped from the cervix and looked at under a microscope).

Colon and Rectal Cancer
It forms in the tissues of the colon (the longest part of the large intestine). Most colon cancers are adenocarcinomas (cancers that begin in cells that make and release mucus and other fluids).It forms in the tissues of the rectum (the last several inches of the large intestine closest to the anus).

Endometrial Cancer
It forms in the tissue lining the uterus (the small, hollow, pear-shaped organ in a woman's pelvis in which a fetus develops). Most endometrial cancers are adenocarcinomas (cancers that begin in cells that make and release mucus and other fluids).

Esophageal Cancer
It forms in tissues lining the esophagus (the muscular tube through which food passes from the throat to the stomach).
Two types of esophageal cancer are squamous cell carcinoma (cancer that begins in flat cells lining the esophagus) and adenocarcinoma (cancer that begins in cells that make and release mucus and other fluids).

Kidney Cancer
It forms in tissues of the kidneys. Kidney cancer includes renal cell carcinoma (cancer that forms in the lining of very small tubes in the kidney that filter the blood and remove waste products) and renal pelvis carcinoma (cancer that forms in the center of the kidney where urine collects). It also includes Wilms tumor, which is a type of kidney cancer that usually develops in children under the age of 5.
Leukemia
It starts in blood-forming tissue such as the bone marrow and causes large numbers of blood cells to be produced and enter the bloodstream

Liver Cancer
Primary liver cancer forms in the tissues of the liver.
Secondary liver cancer that spreads to the liver from another part of the body

Lung Cancer
It forms in tissues of the lung, usually in the cells lining air passages.
The two main types are small cell lung cancer and non-small cell lung cancer. These types are diagnosed based on how the cells look under a microscope
Lymphoma
It begins in cells of the immune system. There are two basic categories of lymphomas. One kind is Hodgkin lymphoma, which is marked by the presence of a type of cell called the Reed-Sternberg cell. The other category is non-Hodgkin lymphomas, which includes a large, diverse group of cancers of immune system cells. Non-Hodgkin lymphomas can be further divided into cancers that have an indolent (slow-growing) course and those that have an aggressive (fast-growing) course. Both Hodgkin and non-Hodgkin lymphomas can occur in children and adults, and prognosis and treatment depend on the stage and the type of cancer

Ovarian Cancer
It forms in tissues of the ovary (one of a pair of female reproductive glands in which the ova, or eggs, are formed). Most ovarian cancers are either ovarian epithelial carcinomas (cancer that begins in the cells on the surface of the ovary) or malignant germ cell tumors (cancer that begins in egg cells).

Pancreatic Cancer
In which malignant (cancer) cells are found in the tissues of the pancreas. Also called exocrine cancer.

Penile Cancer
It forms in the penis (an external male reproductive organ). Most penile cancers are squamous cell carcinomas (cancer that begins in flat cells lining the penis).

Prostate Cancer
It forms in tissues of the prostate (a gland in the male reproductive system found below the bladder and in front of the rectum). Prostate cancer usually occurs in older men.

Skin Cancer
It forms in tissues of the skin. There are several types of skin cancer.
Skin cancer that forms in melanocytes (skin cells that make pigment) is called melanoma.
Skin cancer that forms in basal cells (small, round cells in the base of the outer layer of skin) is called basal cell carcinoma.
Skin cancer that forms in squamous cells (flat cells that form the surface of the skin) is called squamous cell carcinoma.
Skin cancer that forms in neuroendocrine cells (cells that release hormones in response to signals from the nervous system) is called neuroendocrine carcinoma of the skin.
Most skin cancers form in older people on parts of the body exposed to the sun or in people who have weakened immune systems

Stomach Cancer
It forms in tissues lining the stomach. Also called gastric cancer

Cancer Overview

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Cancer is an abnormal growth of cells. Cancer cells rapidly reproduce despite restriction of space, nutrients shared by other cells, or signals sent from the body to stop reproduction. Cancer cells are often shaped differently from healthy cells, they do not function properly, and they can spread to many areas of the body. Tumors, abnormal growth of tissue, are clusters of cells that are capable of growing and dividing uncontrollably; their growth is not regulated.

How Does Cancer Develop?

The organs in our body are made up of cells. Cells divide and multiply as the body needs them. When these cells continue multiplying when the body doesn't need them, the result is a mass or growth, also called a tumor.

These growths are considered either benign or malignant. Benign is considered non-cancerous and malignant is cancerous. Benign tumors rarely are life threatening and do not spread to other parts of the body. They can often be removed.

Malignant tumors, however, often invade nearby tissue and organs, spreading the disease.