"INTERNAL MEDICINE"

Introduction to Infections

2009-12-21T02:13:00.000-08:00

Infectious diseases have been the most important concern for the healthcare officials and department.They have been busy since outset for the prevention and treatment of infectious diseases.These are the diseases which are caused by variety of organisms and micro-organisms including bacteria,viruses,parasites,fungi and other protein particles like prions.
People have been busy in treating these infectious diseases and variety of antibiotics have come into existence due to their work.These drugs include antibacterials,anti virals,anti fungals and antiparasitic.
Latest infectious diseases encountered by mankind are bird flu and swine flu,which is caused by influenza virus types.Infectious disease presentation varies from simple fever to hemorrhagic episodes and sepsis.So immediate care and management of these diseases is mandatory or if overlooked may be devastating

MYASTHENIA GRAVIS

2009-12-19T23:27:00.000-08:00

What is Myasthenia Gravis?
It is an autoimmune disorder of neuromuscular junction(NMJ) resulting in decrease in muscle power and easy fatiguability.

What is its incidence?
It is more common in women as compared to men,mostly before 30 yrs of age.

What are the other causes of Myasthenia Crisis?
Aminoglycosides,D penicillamine and Infections can lead to Myasthenia crisis.

What are the sign and symptoms ?
It results in muscular weakness and fatiguability.Most common groups of muscles involved are ocular,muscles of mastication,speech and proximal muscles.
Respiratory muscles involved can lead to respiratory paralysis.
Ocular muscles paralysis results in Diplopia and extraocular in ptosis.

How is it diagnosed?
Basically a clinical diagnosis but few other investigations can be helpful like
Choline receptor specific antibodies,Tensilon test(Edrophonium),Chest X ray,CT scan and MRI chest.
Blood CP and other biochemical profile is normal however RA factor and ANA are raised.

There is not much role of Muscular Biopsy.

How is it managed?
DRUGS:
Pyridostigmine 60 mg 3 to 4 times daily is used to improve the muscular weakness.

Steroids and Azathiopurine are the drugs used for immunosuppression.

THYMECTOMY.

PLASMAPHERESIS.

HEPATITIS

2009-10-25T20:59:00.000-07:00

What is Hepatitis?
Hepatitis implies injury to the liver characterized by the presence of inflammatory cells in the tissue of the organ.

What is its History?
The name is from ancient Greek hepar, the root being hepat, meaning liver, and suffix -itis, meaning "inflammation".The condition can be self-limiting, healing on its own, or can progress to scarring of the liver.

What are the types of hepatitis?
Hepatitis is acute when it lasts less than six months and chronic when it persists longer.

What are the causes of hepatitis?
A group of viruses known as the hepatitis viruses cause most cases of liver damage worldwide.

Hepatitis can also be due to toxins (notably alcohol), other infections or from autoimmune process.
The common virus causing hepatitis are;

Hep A virus
Hep B virus
Hep C virus
Hep D virus
Hep E virus

Hep A and E run an acute course.
Hep B can have both acute and chronic course.
Hep C most of the times is chronic only.
There cannot be an isolated Hep D virus infection,it usually occurs with Hep Bvirus infection.

What is the clinical course of hepatitis?
It may run a subclinical course when the affected person may not feel ill. The patient becomes
unwell and symptomatic when the disease impairs liver functions that include, among other things,removal of harmful substances, regulation of blood composition, and production of bile to help digestion.

Symptoms of acute hepatitis are usually loss of appetite,dark colored urine,feeling of nausea and
vomitting,low grade fever,distaste to smoking,yellowish discoloration of membranes.

Chronic Hepatitis present usually as Chronic Liver Disease or Cirrhosis.
It can be both compensated and decompensated.

How is Hepatitis diagnosed?
Clinical examination leads to further lab investigations which include;
Liver function tests
Serology for specific type of hepatitis
ElISA method
PCR for Hep Viruses

Other relative investigations are :
USG Abdomen
Prothrombin time
Bile salts

What is the treatment?
Hep A and E acute types have no specific treatment,it take 2 to 3 weeks to recover fully,unlooked

rare cases may go into Fulminant hepatitis??

Hep B and C if diagnosed in time can be cured completely by use of interferons and anti viral drugs

for 6 months to 1 yr duration variably.

Vaccine for Hep B is available in market by name of Engirex.It is very helpful for prevention of

Hep B ,no vaccine for Hep C virus inf is available.

Healthy Eating for a Healthy Weight

2009-10-25T09:23:00.001-07:00

A healthy lifestyle involves many choices. Among them, choosing a balanced diet or eating plan. So how do you choose a healthy eating plan? Let's begin by defining what a healthy eating plan is.
According to the Dietary Guidelines for Americans, a healthy eating plan:
• Emphasizes fruits, vegetables, whole grains, and fat-free or low-fat milk and milk products
• Includes lean meats, poultry, fish, beans, eggs, and nuts
• Is low in saturated fats, trans fats, cholesterol, salt (sodium), and added sugars
• Stays within your daily calorie needs
Eat Healthfully and Enjoy It!
A healthy eating plan that helps you manage your weight includes a variety of foods you may not have considered. If "healthy eating" makes you think about the foods you can't have, try refocusing on all the new foods you can eat—

The Health Effects of Overweight and Obesity

2009-10-25T09:21:00.002-07:00

Research has shown that as weight increases to reach the levels referred to as "overweight" and "obesity,"* the risks for the following conditions also increases:1
• Coronary heart disease
• Type 2 diabetes
• Cancers (endometrial, breast, and colon)
• Hypertension (high blood pressure)
• Dyslipidemia (for example, high total cholesterol or high levels of triglycerides)
• Stroke
• Liver and Gallbladder disease
• Sleep apnea and respiratory problems
• Osteoarthritis (a degeneration of cartilage and its underlying bone within a joint)
• Gynecological problems (abnormal menses, infertility)
*Overweight is defined as a body mass index (BMI) of 25 or higher; obesity is defined as a BMI of 30 or higher.

Physical Activity for a Healthy Weight

2009-10-25T09:14:00.000-07:00

Why is physical activity important?
Regular physical activity is important for good health, and it's especially important if you're trying to lose weight or to maintain a healthy weight.
• When losing weight, more physical activity increases the number of calories your body uses for energy or "burns off." The burning of calories through physical activity, combined with reducing the number of calories you eat, creates a "calorie deficit" that results in weight loss.
• Most weight loss occurs because of decreased caloric intake. However, evidence shows the only way to maintain weight loss is to be engaged in regular physical activity.
• Most importantly, physical activity reduces risks of cardiovascular disease and diabetes beyond that produced by weight reduction alone.
Physical activity also helps to–
• Maintain weight.
• Reduce high blood pressure.
• Reduce risk for type 2 diabetes, heart attack, stroke, and several forms of cancer.
• Reduce arthritis pain and associated disability.
• Reduce risk for osteoporosis and falls.
• Reduce symptoms of depression and anxiety.
How much physical activity do I need?
When it comes to weight management, people vary greatly in how much physical activity they need. Here are some guidelines to follow:
To maintain your weight: Work your way up to 150 minutes of moderate-intensity aerobic activity, 75 minutes of vigorous-intensity aerobic activity, or an equivalent mix of the two each week. Strong scientific evidence shows that physical activity can help you maintain your weight over time. However, the exact amount of physical activity needed to do this is not clear since it varies greatly from person to person. It's possible that you may need to do more than the equivalent of 150 minutes of moderate-intensity activity a week to maintain your weight.
To lose weight and keep it off: You will need a high amount of physical activity unless you also adjust your diet and reduce the amount of calories you're eating and drinking. Getting to and staying at a healthy weight requires both regular physical activity and a healthy eating plan.
What do moderate- and vigorous-intensity mean?
Moderate: While performing the physical activity, if your breathing and heart rate is noticeably faster but you can still carry on a conversation — it's probably moderately intense. Examples include—
• Walking briskly (a 15-minute mile).
• Light yard work (raking/bagging leaves or using a lawn mower).
• Light snow shoveling.
• Actively playing with children.
• Biking at a casual pace.
Vigorous: Your heart rate is increased substantially and you are breathing too hard and fast to have a conversation, it's probably vigorously intense. Examples include—
• Jogging/running.
• Swimming laps.
• Rollerblading/inline skating at a brisk pace.
• Cross-country skiing.
• Most competitive sports (football, basketball, or soccer).
• Jumping rope.
How many calories are used in typical activities?
The following table shows calories used in common physical activities at both moderate and vigorous levels.
Calories Used per Hour in Common Physical Activities
Moderate Physical Activity Approximate Calories/30 Minutes for a 154 lb Person1 Approximate Calories/Hr for a 154 lb Person1
Hiking 185 370
Light gardening/yard work 165 330
Dancing 165 330
Golf (walking and carrying clubs) 165 330
Bicycling (<10 mph) 145 290
Walking (3.5 mph) 140 280
Weight lifting (general light workout) 110 220
Stretching 90 180
Vigorous Physical Activity Approximate Calories/30 Minutes for a 154 lb Person1 Approximate Calories/Hr for a 154 lb Person1
Running/jogging (5 mph) 295 590
Bicycling (>10 mph) 295 590
Swimming (slow freestyle laps) 255 510
Aerobics 240 480
Walking (4.5 mph) 230 460
Heavy yard work (chopping wood) 220 440
Weight lifting (vigorous effort) 220 440
Basketball (vigorous) 220 440
1Calories burned per hour will be higher for persons who weigh more than 154 lbs (70 kg) and lower for persons who weigh less.

STD Prevention Today

2009-10-25T09:11:00.001-07:00

Despite the fact that a great deal of progress has been made in STD prevention over the past four decades, the United States has the highest rates of STD infection in the industrialized world, making prevention as important as ever.
________________________________________
Preventing STD Infection
The most reliable ways to avoid becoming infected with or transmitting STDs are:
Abstain from sexual intercourse (i.e., oral, vaginal, or anal sex)
Be in a long-term, mutually monogamous relationship with an uninfected partner
Latex male condoms, when used consistently and correctly, can reduce the risk of transmission of chlamydia 1, gonorrhea 2, and trichomoniasis.3

________________________________________
Reducing Your Risk of STD Infection
All partners should get tested for HIV and other STDs before initiating sexual intercourse. However, if you decide to be sexually active with a partner whose infection status is unknown or who is infected with HIV or another STD, you can reduce your risk of contracting an STD:
 Ask a new sex partner if he or she has an STD, has been exposed to one, or has any unexplained physical symptoms. Do not have unprotected sex if your partner has signs or symptoms of STDs, such as sores, rashes, or discharge from the genital area. Many common STDs have no symptoms but can still be transmitted to a sexual partner. If your partner has had sexual relations with someone else recently, he or she may have an STD, even if there are no symptoms.
 Use a new condom for each act of insertive intercourse. Correct and consistent use of latex condoms and other barriers can reduce the risk of transmission only when the infected area or site of potential exposure is protected.
 Get regular checkups for STDs (even if you show no symptoms), and be familiar with the common symptoms. Most STDs are readily treated, and the earlier treatment is sought and sex partners are notified, the less likely the disease will do irreparable damage.
________________________________________
Prevention and the CDC
The Division of STD Prevention, part of CDC's National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, coordinates CDC's STD prevention efforts. These efforts include providing national leadership through research, policy development, and support of effective services to prevent sexually transmitted diseases (including HIV infection) and their complications, such as enhanced HIV transmission, infertility, adverse outcomes of pregnancy, and reproductive tract cancer.
CDC's STD Prevention Strategy
The prevention and control of STDs is based on the following five major concepts:
Education and counseling of persons at risk on ways to adopt safer sexual behavior
Identification of infected persons--with or without symptoms--unlikely to seek diagnostic and treatment services
Effective diagnosis and treatment of infected persons
Evaluation, treatment, and counseling of sex partners of persons who are infected with an STD
Pre-exposure vaccination of persons at risk for vaccine-preventable STDs
Primary prevention of STDs begins with changing the sexual behaviors that place persons at risk for infection.4 Moreover, because STD control activities reduce the likelihood of transmission to sex partners, treatment of infected persons constitutes primary prevention of spread within the community.
To enact its strategy, CDC is assisting health departments, healthcare providers, and nongovernmental organizations, and collaborating with other governmental entities, through:
The development, syntheses, translation, and dissemination of timely, science-based information
The development of national goals and science-based policy
The development and support of science-based programs that meet the needs of communities
As the lead agency for STD prevention in the United States, CDC will continue to improve both biomedical and behavioral strategies to combat STDs. Clearly, multiple strategies are required to maintain and improve progress in prevention.

Huma Akram Died Of Multi Organ Failure

2009-10-25T08:12:00.000-07:00

Huma Akram, the wife of former Pakistan captain Wasim Akram died on Sunday. According to reports from Press Trust of India, Huma Akram died at a hospital in Chennai. The wife of Pakistani legendary cricket star was taken to a hospital in Chennai after she suffered multiple organ failure. At the time of her death, Huma Akram was 42 years old. According to reports, on Oct 20, she was admitted at a hospital in Chennai in an emergency situation. The air ambulance carrying Huma had stopped in Chennai after her condition worsened. The air ambulance was going to Singapore from Lahore.

ANESTHETIST

2009-10-23T21:11:00.000-07:00

HISTORY
The word Anesthesia was coined by Oliver Wendell Holmes, Sr. in 1846.

Anesthesia, or anaesthesia , has traditionally meant the condition of having sensation (including the feeling of pain) permanently or temporarily blocked. This allows patients to undergo surgery and other procedures without the distress and pain they would otherwise experience.
Another definition is a "reversible lack of awareness", whether this is a total lack of awareness (e.g. a general anesthetic) or a lack of awareness of a part of the body such as a spinal anesthetic or another nerve block would cause.

DEFINITION
Anesthesia is a pharmacologically induced reversible state of amnesia, analgesia, loss of consciousness, loss of skeletal muscle reflexes and decreased stress response.

ANESTHETIST
Dealer of anesthesia!!!

Hyoglossus

2009-10-23T03:57:00.000-07:00

Hyoglossus Muscle

Origin

It originates from the body and greater horn of hyoid bone

Insertion

It is inserted at the side of the tongue

Action

It retracts and pulls down side of tongue

nerve supply

Its motor nerve supply is by hypoglossal nerve and its sensory nerve supply is by lingual nerve

Flu Shot Girl A hoax !!!!

2009-10-22T20:32:00.000-07:00

Here is a story of a cheer leader which after taking a vaccine of swine flu is now undergoing a serious neurological disorder including dystonias.

Desiree Jennings was a healthy cheerleader for the Washington Redskins.She claims that she developed the disorder Dystonia 10 days after receiving her flu vaccine.

Now among other symptoms she can’t walk forward properly, but (and this is where it gets weird) she can walk backwards or run forwards without any issues. She also has difficulty in talking….

The bizarre nature of her symptoms has left some people believing it’s a hoax, although doctors stress that she’s not putting it on.

Reseacher's are trying to get in depth of the matter.
keep looking!

ASPERGER SYNDROME

2009-10-22T20:29:00.000-07:00

Asperger syndrome is an autism spectrum disorder, and people with it show significant difficulties in social interaction, along with restricted and repetitive patterns of behavior and interests. The difference from other autism disorders is that in it there is relative preservation of linguistic and cognitive development. Physical clumsiness and atypical use of language are frequently reported.

Asperger syndrome is also called Asperger's syndrome,Asperger (or Asperger's) disorder or just Asperger's; it is named after the Austrian pediatrician Hans Asperger .He in 1944, described children in his practice who lacked non verbal communication skills, demonstrated limited empathy with their peers, and were physically clumsy.Fifty years later, it was standardized as a diagnosis, but questions about many aspects remain. For example, there is lingering doubt about whether it is distinct from high functioning autism (HFA);partly because of this, its prevalance is not firmly established. The exact cause is unknown, although research supports the likelihood of a genetic basis; brain imaging techniques have not identified a clear common pathology.

There is no single treatment, and the effectiveness of particular interventions is supported by only limited data. Intervention is aimed at improving symptoms and function. The mainstay of management is behavioral therapy, focusing on specific deficits to address poor communication skills, obsessive or repetitive routines, and physical clumsiness. Most individuals improve over time, but difficulties with communication, social adjustment continue into adulthood. Some researchers and people with Asperger's have advocated a shift in attitudes toward the view that it is a difference, rather than a disability that must be treated or cured

Multiorgan Failure of Cricket Super Star Wasim Akram

2009-10-22T02:28:00.000-07:00

Wife of Pakistani former star cricket player Waseem Akram has been admitted to hospital in India due to abject illness meanwhile, Waseem called nation for offering pray for good health of his wife.

According to sources, Waseem Akram, in his message to nation, has called for prays for the early recovery of his wife (Huma Waseem) from illness.

Actually Huma Akram was on her way to Singapore for her permanent therapy of the illness she is undergoing.

Sadly, Huma is not only suffering from brain tumours (she has three tumours in the brain and needs surgery) but some complications relating to kidney have also developed.actually she developed Multi Organ Failure on her way and was shifted to Hospital in Apollo where she is vitally stable now and kidney functions are deranged mildly.

“Besides being a psychologist, Huma (Akram) is also a hypnotherapist, a wonderful, well grounded lady. I think it is Huma who brings stability and continuity to Wasim Akram’s life"

SCOPOLAMINE

2009-10-22T02:08:00.000-07:00

SCOPOLAMINE

PHARMACOLOGIC CATEGORY

Anticholinergic Agent

REASONS NOT TO TAKE THIS MEDICINE?

If you have an allergy to scopolamine or any other part of this medicine. Tell healthcare provider if you are allergic to any medicine. Make sure to tell about the allergy and how it affected you. This includes telling about rash; hives; itching; shortness of breath; wheezing; cough; swelling of face, lips, tongue, or throat; or any other symptoms involved. If you have any of the following conditions: Fast heartbeat, glaucoma, intestinal blockage, myasthenia gravis, overactive thyroid gland, slow movement through the intestines, or urinary tract blockage.

What is this medicine used for?

This medicine is used to relieve motion sickness.

This medicine is used to treat eye inflammation.

This medicine is used before an eye exam.

This medicine is used to treat irritable bowel syndrome.

This medicine is used to treat muscle spasms of the gastrointestinal tract.

This medicine is used to treat Parkinson's disease.

How does it work?

Scopolamine improves the chemical balance in the brain.

It slows movement through the gastrointestinal tract, decreasing spasms.

It affects the vomiting center in the brain.

It enlarges the pupil of the eye.

How is it best taken?

All forms: Take this medicine with or without food. Take with food if it causes an upset stomach. Drink plenty of noncaffeine-containing liquid unless told to drink less liquid by healthcare provider. If you are taking this medicine for irritable bowel syndrome or spasms of the gastrointestinal tract, take 30-60 minutes before meals.

Eye:

For the eye only.

Take out contact lenses before using medicine. Lenses can be replaced 15 minutes after medicine is given. Do not put contacts back in if eyes are irritated or infected. Do not touch the container tip to the eye, lid, or other skin. Tilt head back and drop medicine into eye. After using medicine, keep your eyes closed. Apply pressure to the inside corner of the eye. Do this for 3-5 minutes. This keeps the medicine in your eye. Separate each eye medicine by 5 minutes.

Skin patch: Use skin patch behind the ear. Use 4 hours before travel starts. Wear only one patch at a time. Wash hands after use. If the patch falls off, replace with a new one. If medicine is needed for more than 3 days, throw away the old patch. Replace with a new one behind the other ear.

What do I do if I miss a dose? (does not apply to patients in the hospital)

Take a missed dose as soon as possible. If it is almost time for the next dose, skip the missed dose and return to your regular schedule. Do not take a double dose or extra doses. Many times this medicine is taken on an as needed basis.

What are the precautions when taking this medicine?

If you are 65 or older, use this medicine with caution. You could have more side effects. May contain conducting metal. Remove patch before MRI. If you have kidney disease, talk with healthcare provider. If you have liver disease, talk with healthcare provider. If you have lung disease, talk with healthcare provider. If you are a male with problems urinating, talk with healthcare provider. Check medicines with healthcare provider. This medicine may not mix well with other medicines. You may not be alert. Avoid driving, doing other tasks or activities until you see how this medicine affects you. Avoid alcohol (includes wine, beer, and liquor) or other medicines and natural products that slow your actions and reactions. These include sedatives, tranquilizers, mood stabilizers, antihistamines, and other pain medicine. You can get sunburned more easily. Avoid sun, sunlamps, and tanning beds. Use sunscreen; wear protective clothing and eyewear. Be careful in hot weather. Drink plenty of fluids to prevent dehydration. Tell healthcare provider if you are pregnant or plan on getting pregnant. Tell healthcare provider if you are breast-feeding.

What are some possible side effects of this medicine?

Feeling lightheaded, sleepy, having blurred vision, or a change in thinking clearly. Avoid driving, doing other tasks or activities that require you to be alert or have clear vision until you see how this medicine affects you. Constipation. More liquids, regular exercise, or a fiber-containing diet may help. Talk with healthcare provider about a stool softener or laxative. Dry mouth. Frequent mouth care, sucking hard, sugar-free candy, or chewing sugar-free gum may help.

What should I monitor?

Change in condition being treated. Is it better, worse, or about the same? Dry mouth may cause an increase in cavities. Take good care of your teeth. See a dentist regularly. Follow up with healthcare provider.

REASONS TO CALL HEALTHCARE PROVIDER IMMEDIATELY

If you suspect an overdose, call your local poison control center or emergency department immediately. Signs of a life-threatening reaction. These include wheezing; chest tightness; fever; itching; bad cough; blue skin color; fits; or swelling of face, lips, tongue, or throat. Severe dizziness or passing out. Significant change in thinking clearly and logically. Unable to pass urine. Sudden change in vision, eye pain or irritation. Any rash. No improvement in condition or feeling worse.

How should I store this medicine? Store at room temperature. Protect tablets from moisture. Do not store in a bathroom or kitchen.

GENERAL STATEMENTS If you have a life-threatening allergy, wear allergy identification at all times. Do not share your medicine with others and do not take anyone else's medicine. Keep all medicine out of the reach of children and pets. Keep a list of all your medicines (prescription, natural products, supplements, vitamins, over-the-counter) with you. Talk with healthcare provider before starting any new medicine, including over-the-counter, natural products, or vitamins.

SARDINIAN DIET

2009-10-21T10:11:00.001-07:00

Interestingly, it's cheese that makes up a large part of the diet. The cheese that's eaten in Sardinia is made from cattle which is fed on grass and is much higher in omega-3 fatty acids than any other cheese. And omega-3s are beneficial against inflammation throughout the body and reducing cholesterol in blood.

Red wine is also a staple of the Sardinian diet -- but it's not some wimpy rose or even pinot. The wine consumed in Sardinia is so dark that it's referred to as "vino nero" or "black wine." Since it's so dark it's loaded with antioxidants which are also beneficial.

Fresh fruits, vegetables and nuts are a staple of the diet and meat is an occasional luxury.

The point of the Sardinian diet is not weight loss (although this will be a side effect) but longevity.

VACCINE H1N1 LOCATIONS AND QUESTION ANSWER SESSION!!

2009-10-20T00:12:00.000-07:00

The long-awaited H1N1 vaccine is expected to arrive next week. At least three vaccine makers have begun shipping to undisclosed distribution centers.

Clinical trials to test the effectiveness and safety of the H1N1 vaccine have been under way for 6 months.

Two types of the vaccine are available: the flu shot, it is an inactivated vaccine containing fragments of killed influenza virus, and a nasal spray, which is made using a weakened live flu virus. The nasal spray will be the first to be widely distributed, however certain groups, including pregnant women, young children and people with compromised immune systems, cannot receive the nasal spray.

No serious side effects are seen and the study subjects who have been immunized have generated a good response.

Vaccine is recommended for certain high-priority groups because they are more likely to have serious complications if they develop swine flu. These groups include: pregnant women; caregivers and household contacts of children younger than 6 months; everyone between the ages of 6 months and 24 years; and people ages 25 to 64 with existing health problems.

Even people who are not in these groups can get the vaccine.

While the first supplies of the H1N1 vaccine are due out next week, that doesn't necessarily mean it will be available in your city. Since only 6 million to 7 million doses are expected next week, you might have to look around for it at the beginning. However, within the next few months there will be plenty of vaccine to go around; 75 million doses will be produced before the end of the year.

LOCATION

Check with your doctor, your children 's school and your local public health department. Right now there's no central list of locations where swine flu vaccine will be offered.

REQUIREMENT OF VACCINE??

It's not a crime to say no to the H1N1 flu vaccine. You won't go to jail, nor will you be fined by the federal government if you decide not to get it. If you're in the military, however, you will be required to get the vaccine, according to the American Forces Press Service. In New York, the state government is requiring the vaccine for health care workers, but there are no penalties built into the law if a worker doesn't comply. Some workers fear they'll lose their jobs if they don't get the vaccine.

I AM A PARENT OF 7 YRS OLD CHILD,DO I NEED THE VACCINATION TOO WITH MY CHILD?

Technically, you, as a parent, don't "need" an H1N1 vaccine because you don't fall into one of the five high-risk groups.However, the team of experts we consulted were unanimous that if there's enough vaccine available, go ahead and get one if you want -- they say it won't hurt you, it will protect you from the flu, and it could help protect your child as well because you won't be bringing the virus home to your child. "If there's plenty of vaccine, it just makes sense to get it,"

VACCINE AND THIMEROSAL?

Some H1N1 shots will contain the preservative thimerosal, and others won't. You'll have to ask your doctor (or the clinic administering the shots) which type you're getting. Some people worry about thimerosal for children because it's mercury-based, but there's no scientific evidence the preservative is harmful.

PREGNANCY AND VACCINATION?

So far, the NIH has vaccinated more than 60 pregnant women as part of a study to see whether the H1N1 vaccine is safe and effective. There have been no reports of serious side effects,

Every pregnant woman needs to decide for herself whether she wants the H1N1 vaccine. The swine flu virus has been particularly dangerous for pregnant women; 6 percent of the people who've died from H1N1 since April have been pregnant women.

Why are pregnant women more vulnerable to H1N1 flu? "It's partly because pregnant women have some degree of compromise of their immune system, and their ability to fight off even fairly common illnesses such as the flu appears to be much lower.

In addition to protecting pregnant women, studies show vaccines give immunity to a newborn for at least a few months as antibodies cross the placenta and reach the fetus. This is especially important since babies cannot get an H1N1 vaccine themselves until they're 6 months old.

By the way, pregnant women and children under age 2 can't get the nasal spray -- the shot is their only option.

The safety/risk profile is the same for EVERY TYPE OF VACCINE ?

A flu shot is a flu shot is a flu shot, according to the Food and Drug Administration, which licenses companies to make vaccines. "All flu vaccine manufacturers use essentially the same technique to produce the seasonal and H1N1 vaccines. They each produce a slightly different version of the vaccine, but all versions adhere to the FDA's stringent standards for safety and effectiveness.

WORLD OSTEOPOROSIS DAY 2OTH OCT

2009-10-19T21:26:00.000-07:00

World Osteoporosis Day provides an all-important focal point for informing and educating the general public and policy makers about the prevention of a disease which still suffers from poor general awareness. With the number of participating countries and scheduled events increasing steadily year by year, the impact of WORLD OSTEOPOROSIS DAY has grown significantly.
WE CARE FOR BONE HEALTH !!

World Osteoporosis Day 2009 (October 20) is the second year of a 'call to action' campaign which seeks to mobilize the power of millions of concerned citizens to work for better osteoporosis healthcare policies in government healthcare systems, private insurance companies, and corporate healthcare networks.

World Osteoporosis Day calls on government health officials across all regions to recognize osteoporosis as a health priority; spread the message that more needs to be done by national governments and health insurers to promote early detection and offer reimbursement of much needed therapy for those with osteoporosis; and to call on individuals to take responsibility for their bone health and to support the work and advocacy efforts of their national osteoporosis societies.

"Stand Tall, Speak Out: Take action to promote osteoporosis policy change"
Calling for change

Osteoporotic fractures are a major cause of suffering, disability and death in the older population and their costs to healthcare services exceed those of many other major chronic diseases. Furthermore, because of the increasing number of elderly people in the population, the number of fractures due to osteoporosis is set to increase two- to three-fold over the next few decades. This imminent increase in the number of people affected poses a major challenge to healthcare systems throughout the world.
Despite significant advances in science and medicine, the reality today is that:

* Between twelve to twenty percent of people die within one year following a hip fracture.
* It is estimated that 80% of those who are at high risk of osteoporosis, and have suffered at least one fracture, have neither been identified nor treated for the disease.
* Many national governments do not treat osteoporosis as a major health priority and fail to provide adequate resources for its detection and treatment.
* Many health insurance schemes (private and public) will not cover diagnosis and treatment prior to the first fracture – even when it is cost effective to do so.

YOU AND SWINE FLU

2009-10-19T09:41:00.000-07:00

You and "Swine Flu"
What is 2009 H1N1 (swine flu)?
2009 H1N1 (sometimes called “swine flu”) is a new influenza virus causing illness in people. This new virus was first detected in people in the United States in April 2009. This virus is spreading from person-to-person worldwide, probably in much the same way that regular seasonal influenza viruses spread. On June 11, 2009, the World Health Organization (WHO) signaled that a pandemic of 2009 H1N1 flu was underway.
Why is 2009 H1N1 virus sometimes called “swine flu”?
This virus was originally referred to as “swine flu” because laboratory testing showed that many of the genes in this new virus were very similar to influenza viruses that normally occur in pigs (swine) in North America. But further study has shown that this new virus is very different from what normally circulates in North American pigs. It has two genes from flu viruses that normally circulate in pigs in Europe and Asia and bird (avian) genes and human genes. Scientists call this a "quadruple reassortant" virus.

Are there human infections with 2009 H1N1 virus in the U.S.?
Yes. Human infections with 2009 H1N1 are ongoing in the United States. Most people who have become ill with this new virus have recovered without requiring medical treatment.

Is 2009 H1N1 virus contagious?
The 2009 H1N1 virus is contagious and is spreading from human to human.
How does 2009 H1N1 virus spread?
Spread of 2009 H1N1 virus is thought to occur in the same way that seasonal flu spreads. Flu viruses are spread mainly from person to person through coughing or sneezing by people with influenza. Sometimes people may become infected by touching something – such as a surface or object – with flu viruses on it and then touching their mouth or nose.
What are the signs and symptoms of this virus in people?
The symptoms of 2009 H1N1 flu virus in people include fever, cough, sore throat, runny or stuffy nose, body aches, headache, chills and fatigue. Some people may have vomiting and diarrhea. People may be infected with the flu, including 2009 H1N1 and have respiratory symptoms without a fever. Severe illnesses and deaths have occurred as a result of illness associated with this virus.
How severe is illness associated with 2009 H1N1 flu virus?
Illness with 2009 H1N1 virus has ranged from mild to severe. While most people who have been sick have recovered without needing medical treatment, hospitalizations and deaths from infection with this virus have occurred.
In seasonal flu, certain people are at “high risk” of serious complications. This includes people 65 years and older, children younger than five years old, pregnant women, and people of any age with certain chronic medical conditions. About 70 percent of people who have been hospitalized with this 2009 H1N1 virus have had one or more medical conditions previously recognized as placing people at “high risk” of serious seasonal flu-related complications. This includes pregnancy, diabetes, heart disease, asthma and kidney disease.
Young children are also at high risk of serious complications from 2009 H1N1, just as they are from seasonal flu. And while people 65 and older are the least likely to be infected with 2009 H1N1 flu, if they get sick, they are also at “high risk” of developing
How long can an infected person spread this virus to others?
People infected with seasonal and 2009 H1N1 flu shed virus and may be able to infect others from 1 day before getting sick to 5 to 7 days after. This can be longer in some people, especially children and people with weakened immune systems and in people infected with the new H1N1 virus.
Prevention & Treatment

What can I do to protect myself from getting sick?
This season, there is a seasonal flu vaccine to protect against seasonal flu viruses and a 2009 H1N1 vaccine to protect against the 2009 H1N1 influenza virus (sometimes called “swine flu”). A flu vaccine is the first and most important step in protecting against flu infection. There are also everyday actions that can help prevent the spread of germs that cause respiratory illnesses like the flu.
Take these everyday steps to protect your health:
Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it.
• Wash your hands often with soap and water. If soap and water are not available, use an alcohol-based hand rub.*
• Avoid touching your eyes, nose or mouth. Germs spread this way.
• Try to avoid close contact with sick people.
• If you are sick with flu-like illness, CDC(Centers for Disease Control and Prevention) recommends that you stay home for at least 24 hours after your fever is gone except to get medical care or for other necessities. (Your fever should be gone without the use of a fever-reducing medicine.) Keep away from others as much as possible to keep from making others sick.
Other important actions that you can take are:
• Follow public health advice regarding school closures, avoiding crowds and other social distancing measures.
• Be prepared in case you get sick and need to stay home for a week or so; a supply of over-the-counter medicines, alcohol-based hand rubs * (for when soap and water are not available), tissues and other related items could help you to avoid the need to make trips out in public while you are sick and contagious.

What is the best way to keep from spreading the virus through coughing or sneezing?
If you are sick with flu-like illness, CDC recommends that you stay home for at least 24 hours after your fever is gone except to get medical care or for other necessities. (Your fever should be gone without the use of a fever-reducing medicine.)
Keep away from others as much as possible. Cover your mouth and nose with a tissue when coughing or sneezing. Put your used tissue in the waste basket. Then, clean your hands, and do so every time you cough or sneeze.
If I have a family member at home who is sick with 2009 H1N1 flu, should I go to work?
Employees who are well but who have an ill family member at home with 2009 H1N1 flu can go to work as usual. These employees should monitor their health every day, and take everyday precautions including covering their coughs and sneezes and washing their hands often with soap and water, especially after they cough or sneeze. If soap and water are not available, they should use an alcohol-based hand rub.* If they become ill, they should notify their supervisor and stay home. Employees who have an underlying medical condition or who are pregnant should call their health care provider for advice, because they might need to receive influenza antiviral
What is the best technique for washing my hands to avoid getting the flu?
Washing your hands often will help protect you from germs. CDC recommends that when you wash your hands -- with soap and warm water -- that you wash for 15 to 20 seconds. When soap and water are not available, alcohol-based disposable hand wipes or gel sanitizers may be used.* You can find them in most supermarkets and drugstores. If using gel, rub your hands until the gel is dry. The gel doesn't need water to work; the alcohol in it kills the germs on your hands.
What are “emergency warning signs” that should signal anyone to seek medical care urgently?
In children:
• Fast breathing or trouble breathing
• Bluish skin color
• Not drinking enough fluids
• Not waking up or not interacting
• Being so irritable that the child does not want to be held
• Flu-like symptoms improve but then return with fever and worse cough
• Fever with a rash
In adults:
• Difficulty breathing or shortness of breath
• Pain or pressure in the chest or abdomen
• Sudden dizziness
• Confusion
• Severe or persistent vomiting
Are there medicines to treat 2009 H1N1 infection?
Yes. There are drugs your doctor may prescribe for treating both seasonal and 2009 H1N1 called “antiviral drugs.” These drugs can make you better faster and may also prevent serious complications. This flu season, antiviral drugs are being used mainly to treat people who are very sick, such as people who need to be hospitalized, and to treat sick people who are more likely to get serious flu complications. Your health care provider will decide whether antiviral drugs are needed to treat your illness. Remember, most people with 2009 H1N1 have had mild illness and have not needed medical care or antiviral drugs and the same is true of seasonal flu.
Contamination & Cleaning

How long can influenza virus remain viable on objects (such as books and doorknobs)?
Studies have shown that influenza virus can survive on environmental surfaces and can infect a person for 2 to 8 hours after being deposited on the surface.
What kills influenza virus?
Influenza virus is destroyed by heat (167-212°F [75-100°C]). In addition, several chemical germicides, including chlorine, hydrogen peroxide, detergents (soap), iodophors (iodine-based antiseptics), and alcohols are effective against human influenza viruses if used in proper concentration for a sufficient length of time.
*What if soap and water are not available and alcohol-based products are not allowed in my facility?
If soap and water are not available and alcohol-based products are not allowed, other hand sanitizers that do not contain alcohol may be useful.
What surfaces are most likely to be sources of contamination?
Germs can be spread when a person touches something that is contaminated with germs and then touches his or her eyes, nose, or mouth. Droplets from a cough or sneeze of an infected person move through the air. Germs can be spread when a person touches respiratory droplets from another person on a surface like a desk, for example, and then touches their own eyes, mouth or nose before washing their hands.
How should waste disposal be handled to prevent the spread of influenza virus?
To prevent the spread of influenza virus, it is recommended that tissues and other disposable items used by an infected person be thrown in the trash. Additionally, persons should wash their hands with soap and water after touching used tissues and similar waste.
What household cleaning should be done to prevent the spread of influenza virus?
To prevent the spread of influenza virus it is important to keep surfaces (especially bedside tables, surfaces in the bathroom, kitchen counters and toys for children) clean by wiping them down with a household disinfectant according to directions on the product label.
How should linens, eating utensils and dishes of persons infected with influenza virus be handled?
Linens, eating utensils, and dishes belonging to those who are sick do not need to be cleaned separately, but importantly these items should not be shared without washing thoroughly first.
Linens (such as bed sheets and towels) should be washed by using household laundry soap and tumbled dry on a hot setting. Individuals should avoid "hugging" laundry prior to washing it to prevent contaminating themselves. Individuals should wash their hands with soap and water or alcohol-based hand rub immediately after handling dirty laundry.
Eating utensils should be washed either in a dishwasher or by hand with water and soap.

Can I get infected with 2009 H1N1 virus from eating or preparing pork?
No. 2009 H1N1 viruses are not spread by food. You cannot get infected with novel HIN1 virus from eating pork or pork products. Eating properly handled and cooked pork products is safe.
Is there a risk from drinking water?
Tap water that has been treated by conventional disinfection processes does not likely pose a risk for transmission of influenza viruses. Current drinking water treatment regulations provide a high degree of protection from viruses. No research has been completed on the susceptibility of 2009 H1N1 flu virus to conventional drinking water treatment processes. However, recent studies have demonstrated that free chlorine levels typically used in drinking water treatment are adequate to inactivate highly pathogenic H5N1 avian influenza. It is likely that other influenza viruses such as 2009 H1N1 would also be similarly inactivated by chlorination. To date, there have been no documented human cases of influenza caused by exposure to influenza-contaminated drinking water.
Can 2009 H1N1 flu virus be spread through water in swimming pools, spas, water parks, interactive fountains, and other treated recreational water venues?
Influenza viruses infect the human upper respiratory tract. There has never been a documented case of influenza virus infection associated with water exposure. Recreational water that has been treated at CDC recommended disinfectant levels does not likely pose a risk for transmission of influenza viruses. No research has been completed on the susceptibility of 2009 H1N1 influenza virus to chlorine and other disinfectants used in swimming pools, spas, water parks, interactive fountains, and other treated recreational venues. However, recent studies have demonstrated that free chlorine levels recommended by CDC (1–3 parts per million [ppm or mg/L] for pools and 2–5 ppm for spas) are adequate to disinfect avian influenza A (H5N1) virus. It is likely that other influenza viruses such as 2009 H1N1 virus would also be similarly disinfected by chlorine.
Can 2009 H1N1 influenza virus be spread at recreational water venues outside of the water?
Yes, recreational water venues are no different than any other group setting. The spread of this 2009 H1N1 flu is thought to be happening in the same way that seasonal flu spreads. Flu viruses are spread mainly from person to person through coughing or sneezing of people with influenza. Sometimes people may become infected by touching something with flu viruses on it and then touching their mouth or nose.

MENINGITIS

2009-10-19T09:14:00.001-07:00

Meningitis
Q: What is meningitis?
A: Meningitis is an inflammation of the membranes that cover the brain and spinal cord. People sometimes refer to it as spinal meningitis. Meningitis is usually caused by a viral or bacterial infection. Knowing whether meningitis is caused by a virus or bacterium is important because the severity of illness and the treatment differ depending on the cause. Viral meningitis is generally less severe and clears up without specific treatment. But bacterial meningitis can be quite severe and may result in brain damage, hearing loss, or learning disabilities. For bacterial meningitis, it is also important to know which type of bacteria is causing the meningitis because antibiotics can prevent some types from spreading and infecting other people. Before the 1990s, Haemophilus influenzae type b (Hib) was the leading cause of bacterial meningitis. Hib vaccine is now given to all children as part of their routine immunizations. This vaccine has reduced the number of cases of Hib infection and the number of related meningitis cases. Today, Streptococcus pneumoniae and Neisseria meningitidis are the leading causes of bacterial meningitis.
Q: What are the signs and symptoms of meningitis?
A: High fever, headache, and stiff neck are common symptoms of meningitis in anyone over the age of 2 years. These symptoms can develop over several hours, or they may take 1 to 2 days. Other symptoms may include nausea, vomiting, discomfort looking into bright lights, confusion, and sleepiness. In newborns and small infants, the classic symptoms of fever, headache, and neck stiffness may be absent or difficult to detect. Infants with meningitis may appear slow or inactive, have vomiting, be irritable, or be feeding poorly. As the disease progresses, patients of any age may have seizures.
Bacterial Meningitis
Q: How is bacterial meningitis diagnosed?
A: Early diagnosis and treatment are very important. If symptoms occur, the patient should see a doctor immediately. The diagnosis is usually made by growing bacteria from a sample of spinal fluid. The spinal fluid is obtained by performing a spinal tap, in which a needle is inserted into an area in the lower back where fluid in the spinal canal can be collected. Identification of the type of bacteria responsible is important for selection of correct antibiotics.
Q: Can bacterial meningitis be treated?
A: Bacterial meningitis can be treated with a number of effective antibiotics. It is important, however, that treatment be started early in the course of the disease. Appropriate antibiotic treatment of most common types of bacterial meningitis should reduce the risk of dying from meningitis to below 15%, although the risk is higher among the elderly.
Q: Is bacterial meningitis contagious?
A: Yes, some forms of bacterial meningitis are contagious. The bacteria can mainly be spread from person to person through the exchange of respiratory and throat secretions. This can occur through coughing, kissing, and sneezing. Fortunately, none of the bacteria that cause meningitis are as contagious as things like the common cold or the flu. Also, the bacteria are not spread by casual contact or by simply breathing the air where a person with meningitis has been.
However, sometimes the bacteria that cause meningitis have spread to other people who have had close or prolonged contact with a patient with meningitis caused by Neisseria meningitidis (also called meningococcal meningitis) or Hib. People in the same household or daycare center, or anyone with direct contact with a patient's oral secretions (such as a boyfriend or girlfriend) would be considered at increased risk of getting the infection. People who qualify as close contacts of a person with meningitis caused by N. meningitidis should receive antibiotics to prevent them from getting the disease. This is known as prophylaxis. Prophylaxis for household contacts of someone with Hib disease is only recommended if there is 1 household contact younger than 48 months who has not been fully immunized against Hib or an immunocompromised child (a child with a weakened immune system) of any age is in the household. The entire household, regardless of age, should receive prophylaxis in these cases.
Q: Are there vaccines against bacterial meningitis?
A: Yes, there are vaccines against Hib, against some serogroups of N. meningitidis and many types of Streptococcus pneumoniae. The vaccines are safe and highly effective.
The Advisory Committee on Immunization Practices (ACIP) recommends routine vaccination of all persons aged 11-18 years of age with 1 dose of MCV4, the meningococcal conjugate vaccine known as Menactra®, at the earliest opportunity. Pre-teens who are 11-12 years old should be routinely vaccinated at the 11-12 year old check-up as recommended by ACIP. This visit is the best time for adolescents to receive MCV4. Also, since the occurrence of meningococcal disease increases during adolescence, health-care providers should vaccinate previously unvaccinated pre-teens and teens aged 11-18 years with MCV4 at the earliest possible health-care visit.
College freshmen living in dormitories are at increased risk for meningococcal disease and should be vaccinated with MCV4 before college entry if they have not previously been vaccinated. The risk for meningococcal disease among nonfreshmen college students is similar to that for the general population of similar age (age 18-24 years). However, since the vaccines are safe and produce immunity, they can be provided to nonfreshmen college students who want to reduce their risk for meningococcal disease.
Routine vaccination also is recommended for certain persons who have increased risk for meningococcal disease. Use of MCV4 is preferred among people aged 2-55 years; however, use of MPSV4, the meningococcal polysaccharide vaccine known as Menomune®, is recommended among adults over 55 years of age.
There are also vaccines to prevent meningitis due to S. pneumoniae (also called pneumococcal meningitis), which can also prevent other forms of infection due to S. pneumoniae. The pneumococcal polysaccharide vaccine (PPV23) is recommended for all persons over 65 years of age and younger persons at least 2 years old with certain chronic medical problems. There is a vaccine (pneumococcal conjugate vaccine, or PCV7) that is effective in infants for the prevention of pneumococcal infections and is routinely recommended for all children younger than 2 years of age.

Viral Meningitis
Q: What is viral meningitis?
A: Meningitis is an inflammation of the membranes ("meninges") that cover the brain and spinal cord. Viral infections are the most common cause of meningitis; bacterial infections are the second most common cause. Other, rarer causes of meningitis include fungi, parasites, and non-infectious causes, including those that are related to drugs.
Meningitis caused by viral infections is sometimes called "aseptic meningitis."
Q: Is viral meningitis a serious disease?
A: Viral ("aseptic") meningitis is serious but rarely fatal in people with normal immune systems. Usually, the symptoms last from 7 to 10 days and the patient recovers completely. Bacterial meningitis, on the other hand, can be very serious and result in disability or death if not treated promptly. Often, the symptoms of viral meningitis and bacterial meningitis are the same. For this reason, if you think you or your child has meningitis, see your doctor as soon as possible.
Q: What causes viral meningitis?
A: Different viral infections can lead to viral meningitis. But most cases in the United States, particularly during the summer and fall months, are caused by enteroviruses (which include enteroviruses, coxsackieviruses, and echoviruses). Most people who are infected with enteroviruses either have no symptoms or only get a cold, rash, or mouth sores with low-grade fever. And, only a small number of people with enterovirus infections go on to develop meningitis.
Other viral infections that can lead to meningitis include mumps, herpesvirus (such as Epstein-Barr virus, herpes simplex viruses, and varicella-zoster virus—the cause of chickenpox and shingles), measles, and influenza.
Arboviruses, which mosquitoes and other insects spread, can also cause infections that can lead to viral meningitis. And lymphocytic choriomeningitis virus, which is spread by rodents, is a rare cause of viral meningitis.
Q: What are the signs and symptoms of viral meningitis?
A: Symptoms can appear quickly or they can also take several days to appear, usually after a cold or runny nose, diarrhea, vomiting, or other signs of infection show up. Symptoms in adults may differ from those in children:
• Common in infants
o Fever
o Irritability
o Poor eating
o Hard to awaken
• Common in older children and adults
o High fever
o Severe headache
o Stiff neck
o Sensitivity to bright light
o Sleepiness or trouble waking up
o Nausea, vomiting
o Lack of appetite
Q: How is viral meningitis diagnosed?
A: Viral meningitis is usually diagnosed by laboratory tests of a patient’s spinal. The test can reveal whether the patient is infected with a virus or a bacterium. The exact cause of viral meningitis can sometimes be found through tests that show which virus has infected a patient; however, identifying the exact virus causing meningitis may be difficult.
Because the symptoms of viral meningitis are similar to those of bacterial meningitis, which is usually more severe and can be fatal, it is important for people suspected of having meningitis to seek medical care and have their spinal fluid tested. A hospital stay may be necessary in more severe cases or for people with weak immune systems.
Q: How is viral meningitis treated?
A: There is no specific treatment for viral meningitis. Most patients completely recover on their own within 2 weeks. Antibiotics do not help viral infections, so they are not useful in the treatment of viral meningitis. Doctors often will recommend bed rest, plenty of fluids, and medicine to relieve fever and headache.
A hospital stay may be necessary in more severe cases or for people with weak immune systems.
Q: How is the virus spread?
A: Different viruses that cause viral meningitis are spread in different ways. Enteroviruses, the most common cause of viral meningitis, are most often spread through direct contact with an infected person’s stool. The virus is spread through this route mainly among small children who are not yet toilet trained. It can also be spread this way to adults changing the diapers of an infected infant.
Enteroviruses and other viruses (such as mumps and varicella-zoster virus) can also be spread through direct or indirect contact with respiratory secretions (saliva, sputum, or nasal mucus) of an infected person. This usually happens through kissing or shaking hands with an infected person or by touching something they have handled and then rubbing your own nose or mouth. The viruses can also stay on surfaces for days and can be transferred from objects. Viruses also can spread directly when infected people cough or sneeze and send droplets containing the virus into the air we breathe.
The time from when a person is infected until they develop symtoms (incubation period) is usually between 3 and 7 days for enteroviruses. An infected person is usually contagious from the time they develop symptoms until the symptoms go away. Young children and people with low immune systems may spread the infection even after symptoms have resolved.
Q: Can I get viral meningitis if I’m around someone who has it?
A: If you are around someone with viral meningitis, you may be at risk of becoming infected with the virus that made them sick. But you have only a small chance of developing meningitis as a complication of the illness.
Q: How can I reduce my chances of becoming infected with viruses that can lead to viral meningitis?
A: Viral meningitis most commonly results from infection with enteroviruses. But there are other causes, such as measles, mumps, and chickenpox. Viral meningitis can also be caused by viruses that are spread by mosquitoes and other insects that bite people.
The specific measures for preventing or reducing your risk for viral meningitis depend on the cause.
• Following good hygiene practices can reduce the spread of viruses, such as enteroviruses, herpesviruses, and measles and mumps viruses. Preventing the spread of virus can be difficult, especially since sometimes people are infected with a virus (like an enterovirus) but do not appear sick. In such cases, infected people can still spread the virus to others. Thus, it is important to always practice good hygiene to help reduce your chances of becoming infected with a virus or of passing one on to someone else:
o Wash your hands thoroughly and often. This is especially important after changing diapers, using the toilet, or coughing or blowing your nose in a tissue.
o Cleaning contaminated surfaces, such as handles and doorknobs or the TV remote control, with soap and water and then disinfecting them with a dilute solution of chlorine-containing bleach also may decrease the spread of viruses. This solution can be made by mixing ¼ cup of bleach with 1 gallon (16 cups) of water.
o Cover your cough. The viruses that cause viral meningitis can be spread by direct and indirect contact with respiratory secretions, so it is important to cover your cough with a tissue or, if you do not have a tissue, to cough into your upper arm. After using a tissue, place it in the trash and wash your hands.
o Avoid kissing or sharing a drinking glass, eating utensil, lipstick, or other such items with sick people or with others when you are sick.
• Receiving vaccinations included in the childhood vaccination schedule can protect children against some diseases that can lead to viral meningitis. These include vaccines against measles and mumps (the MMR vaccine) and chickenpox (the varicella-zoster vaccine).
• Avoiding bites from mosquitoes and other insects that carry diseases that can infect humans may help reduce your risk for viral meningitis.

GENITAL HERPES

2009-10-19T08:18:00.000-07:00

Genital herpes is a sexually transmitted disease (STD) caused by the herpes simplex viruses type 1 (HSV-1) or type 2 (HSV-2). Most genital herpes is caused by HSV-2. Most individuals have no or only minimal signs or symptoms from HSV-1 or HSV-2 infection. When signs do occur, they typically appear as one or more blisters on or around the genitals or rectum. The blisters break, leaving tender ulcers (sores) that may take two to four weeks to heal the first time they occur. Typically, another outbreak can appear weeks or months after the first, but it almost always is less severe and shorter than the first outbreak. Although the infection can stay in the body indefinitely, the number of outbreaks tends to decrease over a period of years.

Results of a nationally representative study show that genital herpes infection is common in the United States. Nationwide, at least 45 million people ages 12 and older, or one out of five adolescents and adults, have had genital HSV infection. Over the past decade, the percent of Americans with genital herpes infection in the U.S. has decreased.
Genital HSV-2 infection is more common in women (approximately one out of four women) than in men (almost one out of eight). This may be due to male-to-female transmission being more likely than female-to-male transmission.

HSV-1 and HSV-2 can be found in and released from the sores that the viruses cause, but they also are released between outbreaks from skin that does not appear to have a sore. Generally, a person can only get HSV-2 infection during sexual contact with someone who has a genital HSV-2 infection. Transmission can occur from an infected partner who does not have a visible sore and may not know that he or she is infected.
HSV-1 can cause genital herpes, but it more commonly causes infections of the mouth and lips, so-called “fever blisters.” HSV-1 infection of the genitals can be caused by oral-genital or genital-genital contact with a person who has HSV-1 infection. Genital HSV-1 outbreaks recur less regularly than genital HSV-2 outbreaks.

Most people infected with HSV-2 are not aware of their infection. However, if signs and symptoms occur during the first outbreak, they can be quite pronounced. The first outbreak usually occurs within two weeks after the virus is transmitted, and the sores typically heal within two to four weeks. Other signs and symptoms during the primary episode may include a second crop of sores, and flu-like symptoms, including fever and swollen glands. However, most individuals with HSV-2 infection never have sores, or they have very mild signs that they do not even notice or that they mistake for insect bites or another skin condition.
People diagnosed with a first episode of genital herpes can expect to have several (typically four or five) outbreaks (symptomatic recurrences) within a year. Over time these recurrences usually decrease in frequency. It is possible that a person becomes aware of the “first episode” years after the infection is acquired.

Genital herpes can cause recurrent painful genital sores in many adults, and herpes infection can be severe in people with suppressed immune systems. Regardless of severity of symptoms, genital herpes frequently causes psychological distress in people who know they are infected.
In addition, genital HSV can lead to potentially fatal infections in babies. It is important that women avoid contracting herpes during pregnancy because a newly acquired infection during late pregnancy poses a greater risk of transmission to the baby. If a woman has active genital herpes at delivery, a cesarean delivery is usually performed. Fortunately, infection of a baby from a woman with herpes infection is rare.
Herpes may play a role in the spread of HIV, the virus that causes AIDS. Herpes can make people more susceptible to HIV infection, and it can make HIV-infected individuals more infectious.

The signs and symptoms associated with HSV-2 can vary greatly. Health care providers can diagnose genital herpes by visual inspection if the outbreak is typical, and by taking a sample from the sore(s) and testing it in a laboratory. HSV infections can be diagnosed between outbreaks by the use of a blood test. Blood tests, which detect antibodies to HSV-1 or HSV-2 infection, can be helpful, although the results are not always clear-cut.

There is no treatment that can cure herpes, but antiviral medications can shorten and prevent outbreaks during the period of time the person takes the medication. In addition, daily suppressive therapy for symptomatic herpes can reduce transmission to partners.

The surest way to avoid transmission of sexually transmitted diseases, including genital herpes, is to abstain from sexual contact, or to be in a long-term mutually monogamous relationship with a partner who has been tested and is known to be uninfected.
Genital ulcer diseases can occur in both male and female genital areas that are covered or protected by a latex condom, as well as in areas that are not covered. Correct and consistent use of latex condoms can reduce the risk of genital herpes.
Persons with herpes should abstain from sexual activity with uninfected partners when lesions or other symptoms of herpes are present. It is important to know that even if a person does not have any symptoms he or she can still infect sex partners. Sex partners of infected persons should be advised that they may become infected and they should use condoms to reduce the risk. Sex partners can seek testing to determine if they are infected with HSV. A positive HSV-2 blood test most likely indicates a genital herpes infection.

BIRD FLU

2009-10-19T08:17:00.000-07:00

Avian Influenza (Bird Flu)

How is avian influenza detected in humans?

Avian influenza cannot be diagnosed by symptoms alone, so a laboratory test is required. Avian influenza is usually diagnosed by collecting a swab from the nose or throat during the first few days of illness. This swab is then sent to a laboratory, where they will either look for avian influenza virus using a molecular test, or they will try to grow the virus. Growing avian influenza viruses should only be done in laboratories with high levels of protection. If it is late in the illness, it may be difficult to find an avian influenza virus directly using these methods. If this is the case, it may still be possible to diagnose avian influenza by looking for evidence of the body's response to the virus. This is not always an option because it requires two blood specimens (one taken during the first few days of illness and another taken some weeks later), and it can take several weeks to verify the results.

What are the implications of avian influenza to human health?

Two main risks for human health from avian influenza are 1) the risk of direct infection when the virus passes from the infected bird to humans, sometimes resulting in severe disease; and 2) the risk that the virus – if given enough opportunities – will change into a form that is highly infectious for humans and spreads easily from person to person.

Does seasonal influenza vaccine protect against avian influenza infection in people?

No. Seasonal influenza vaccine does not provide protection against avian influenza.

Should I wear a surgical mask to prevent exposure to avian influenza?

Currently, wearing a mask is not recommended for routine use (e.g., in public) for preventing influenza exposure. In the United States, disposable surgical and procedure masks have been widely used in health-care settings to prevent exposure to respiratory infections, but the masks have not been used commonly in community settings, such as schools, businesses, and public gatherings.

Can I get avian influenza from eating or preparing poultry or eggs?

You cannot get avian influenza from properly handled and cooked poultry and eggs.

There currently is no scientific evidence that people have been infected with bird flu by eating safely handled and properly cooked poultry or eggs.

Most cases of avian influenza infection in humans have resulted from direct or close contact with infected poultry or surfaces contaminated with secretions and excretions from infected birds. Even if poultry and eggs were to be contaminated with the virus, proper cooking would kill it. In fact, recent studies have shown that the cooking methods that are already recommended by the U.S. Department of Agriculture (USDA) and the Food and Drug Administration (FDA) for poultry and eggs to prevent other infections will destroy influenza viruses as well.

So to stay safe, the advice is the same for protecting against any infection from poultry:

Wash your hands with soap and warm water for at least 20 seconds before and after handling raw poultry and eggs.
Clean cutting boards and other utensils with soap and hot water to keep raw poultry from contaminating other foods.
Use a food thermometer to make sure you cook poultry to a temperature of at least 165 degrees Fahrenheit Consumers may wish to cook poultry to a higher temperature for personal preference.
Cook eggs until whites and yolks are firm.

The U.S. government carefully controls domestic and imported food products, and in 2004 issued a ban on importation of poultry from countries affected by avian influenza viruses, including the H5N1 strain. This ban still is in place.

We have a small flock of chickens. Is it safe to keep them?

Yes. In the United States there is no need at present to remove a flock of chickens because of concerns regarding avian influenza. The U.S. Department of Agriculture monitors potential infection of poultry and poultry products by avian influenza viruses and other infectious disease agents.

Human infection with avian influenza viruses

There are many different subtypes of type A influenza viruses. These subtypes differ because of changes in certain proteins on the surface of the influenza A virus (hemagglutinin [HA] and neuraminidase [NA] proteins). There are 16 known HA subtypes and 9 known NA subtypes of influenza A viruses. Many different combinations of HA and NA proteins are possible. Each combination represents a different subtype. All known subtypes of influenza A viruses can be found in birds.

Usually, “avian influenza virus” refers to influenza A viruses found chiefly in birds, but infections with these viruses can occur in humans. The risk from avian influenza is generally low to most people, because the viruses do not usually infect humans. However, confirmed cases of human infection from several subtypes of avian influenza infection have been reported since 1997. Most cases of avian influenza infection in humans have resulted from contact with infected poultry (e.g., domesticated chicken, ducks, and turkeys) or surfaces contaminated with secretion/excretions from infected birds. The spread of avian influenza viruses from one ill person to another has been reported very rarely, and has been limited, inefficient and unsustained.

INFLUENZA VIRUS:

“Human influenza virus” usually refers to those subtypes that spread widely among humans. There are only three known A subtypes of influenza viruses (H1N1, H1N2, and H3N2) currently circulating among humans. It is likely that some genetic parts of current human influenza A viruses came from birds originally. Influenza A viruses are constantly changing, and they might adapt over time to infect and spread among humans.

Influenza A (H5N1) virus – also called “H5N1 virus” – is an influenza A virus subtype that occurs mainly in birds, is highly contagious among birds, and can be deadly to them. H5N1 virus does not usually infect people, but infections with these viruses have occurred in humans. Most of these cases have resulted from people having direct or close contact with H5N1-infected poultry or H5N1-contaminated surfaces.

AT RISK:

During an outbreak of avian influenza among poultry, there is a possible risk to people who have contact with infected birds or surfaces that have been contaminated with secretions or excretions from infected birds.

SYMPTOMS:

Symptoms of avian influenza in humans have ranged from typical human influenza-like symptoms (e.g., fever, cough, sore throat, and muscle aches) to eye infections, pneumonia, severe respiratory diseases (such as acute respiratory distress), and other severe and life-threatening complications. The symptoms of avian influenza may depend on which virus caused the infection.

Treatment and vaccination for H5N1 virus in humans

Studies done in laboratories suggest that some of the prescription medicines approved in the United States for human influenza viruses should work in treating avian influenza infection in humans. However, influenza viruses can become resistant to these drugs, so these medications may not always work. Additional studies are needed to demonstrate the effectiveness of these medicines.

The H5N1 virus that has caused human illness and death in Asia is resistant to amantadine and rimantadine, two antiviral medications commonly used for influenza. Two other antiviral medications, oseltamivir and zanamivir, would probably work to treat influenza caused by H5N1 virus, but additional studies still need to be done to demonstrate their effectiveness.

Smoking and TB!

2009-10-19T02:07:00.000-07:00

Smokers are twice as likely to develop active tuberculosis compared to people who have never smoked, prompting a call for policymakers to be tougher on smoking.

One thirds of the world’s population is infected with TB, but 90 percent of these remain latent . The remaining 10 percent develop active TB at some point of life because of weak immunity. Many people who are infected with HIV/AIDS fall sick and die from TB.TB is still the leading cause of death in the world. There were 9.3 million new cases of TB in 2007 and 1.8 million deaths,according to a study. The World Health Organization aims to bring the incidence of TB down to one case per million each year by 2050.

17,699 participants above 12 years of age were studied in Taiwan to investigate the association between cigarette smoking and active tuberculosis in the general population. The participants were tracked three years. Out of 17,699 participants, 3,893 were current smokers, 552 were former smokers and 13,254 had never smoked. Data regarding the sex, age, living in a crowded home, household income, marital status, alcohol use and employment of participants was also collected.

Fifty-seven new cases of active TB were diagnosed at the end of the three-year follow-up. It was found that current smokers had a higher risk of developing active TB. Current smokers had a two-fold higher risk of active TB compared with those who had never smoked, and 17 percent of active TB cases in this population were due to smoking.

The researchers concluded that smokers have a decreased ability to fight infections, such as TB, and suggested policymakers and public health personnel to consider addressing tobacco cessation as part of tuberculosis control.

Relenza saves a life

2009-10-19T00:50:00.000-07:00

In Britain doctors have saved the life of a woman with severe swine flu after giving her an intravenous form of GlaxoSmithKline's drug Relenza.

Relenza, or zanamivir, is currently only approved as an inhaled medicine. This version, however, did not work in the 22-year-old patient, whose immune system was impaired due to recent chemotherapy.

She also did not respond to Tamiflu, or oseltamivir, which is given as a pill.

Doctors at University College London therefore decided to try intravenous Relenza in combination with high-dose corticosteroids and her condition improved within 2 days.

"Although this is a single case report and direct cause and effect cannot be confirmed, the improvement in clinical status following intravenous Relenza encourages prompt further investigation."

The new H1N1 swine flu was declared a pandemic in June and has been spreading globally since then.

Other flu drugs are under development to deal with seasonal and pandemic influenza. One that has shown promise in intravenous form is Peramivir.

ASBESTOSIS

2009-10-19T00:40:00.000-07:00

For miners who are always around asbestos, there is always a higher risk of lung cancer. Especially a certain type of lung cancer including pleura, called mesothelioma. However, there is another lung abnormality that asbestos workers get as well, which is called asbestosis. Asbestosis is the inflammation of the parenchymal tissue of the lungs. It results in shortness of breath and a higher chance of lung cancer.

After inhaling asbestos ,lung tissue will scar, this scarring causes the inflammation in the lung that is asbestosis. The asbestos fibers will activate the body’s own natural immune system to attack, and this causes inflammation in the lung cavities. It is a slow and chronic condition. It contributes to scar tissue, which will build up and restrict the lungs activity. It reduces the oxygen flow and inhibits carbon dioxide removal. This is where oxygen therapy can help with the breathing difficulties and the shortness of breath.

Signs and Symptoms

There are not many signs to having asbestosis other than shortness of breath. After a prolonged and advanced case of asbestosis there may be cough and respiratory failure. Like mesothelioma, asbestosis can take a decade or so after first exposure to the asbestos. There can be a very long dormant period from exposure to symptoms, however whenever there is breathing and respiratory problems in anyone who has ever had exposure to asbestos should be considered viable hosts for asbestosis or mesothelioma.

Management

Currently there is not much treatment that is widely available for asbestosis. Some things that may help are long term oxygen therapy. Oxygen therapy can help with the breathing difficulties and increase the concentration of oxygen in the body.

Other items include postural drainage of the lungs to take out any liquid secretions and increase lung capacity and breathing. Some form of nebulizers, like those used in COPD and asthma sufferers, can also be prescribed so that the secretions in the lungs can be diluted and patients may be able to breathe better from this as well.

Because of so many asbestos related conditions such as asbestosis and mesothelioma, legal cases have been being fought in our courts since 1929. Liability for asbestos and working near asbestos is a serious business, in both the cost to companies that try to skirt the system and by the healthcare costs to their employees. Asbestos specialty lawyers command top dollar due to the payouts in those types of cases.

CO PEPTIN A BENEFICIAL BIOMARKER IN ACUTE MI

2009-10-18T22:57:00.001-07:00

New biochemical markers significantly improve the early detection of acute myocardial infarction (AMI). Recent studies reveal a promising way for doctors to conclusively ensure that a patient is having or not having an AMI in a timely and accurate manner earning time and money.

In patients presenting with chest pain and suspected AMI doctors rely on detailed patient assessment, the ECG, and the measurement of cardiac troponins(T and I) (specific markers for dying cells in the heart). AMI is the cause of death in more persons worldwide than any other disease. With effective treatment within our grasp, accurate and rapid diagnosis is of major medical and economic importance. With the development of blood tests depicting either cardiac troponin I or cardiac troponin T, the only current biomarkers thought to be unique to the heart, the diagnosis of AMI has been veritably revolutionised. In a patient presenting with chest pain, a rise in cardiac troponin has become a mandatory feature for the clinical diagnosis of AMI. Unfortunately, current cardiac troponin assays have one major limitation in common with their predecessor (CK-MB): it takes 3𔃂 hours after symptom onset until cardiac troponin becomes detectable. This is a major problem for doctors and causes diagnostic uncertainty particularly in patients presenting within the first hours from chest pain onset.

Recently, data from large multicenter studies have become available that demonstrate for the first time the impact of two novel biomarkers and therefore two novel approaches in the early diagnosis of AMI: sensitive cardiac troponin assays and copeptin, a marker of endogenous stress, in combination with standard cardiac troponin. Both approaches seem to largely overcome the sensitivity deficit of current standard cardiac troponin.

The more sensitive the cardiac troponin assay used, the smaller the number of dying myocardial cells necessary for this signal to be detected. Recent studies have clearly shown that sensitive cardiac troponin assays have a significantly higher diagnostic accuracy for the diagnosis of AMI and enable doctors to detect AMI already at presentation to the emergency department in the vast majority of patients.

A rapid diagnosis of AMI may reduce complications by allowing for earlier revascularization, earlier transfer to the coronary care unit, and earlier initiation of evidence-based treatment for AMI. In addition, the sensitive cardiac troponin assays may make it possible to reliably rule out the diagnosis of AMI in many patients on the basis of the initial measurement. The negative predictive value of the 99th percentile of the sensitive cardiac troponin assays, used as a single variable, was 97 to 99%. When sensitive cardiac troponin assays are used in conjunction with a clinical assessment and ECG, they will substantially reduce the percentage of patients in whom the diagnosis is uncertain after the first cardiac troponin measurement and for whom continuous ECG monitoring and serial blood sampling is necessary. The cost savings associated with this increase in early diagnostic accuracy might be substantial.

Similar findings were reported for the combination of copeptin and standard cardiac troponin. Copeptin, the C-terminal part of the vasopressin prohormone, is a marker of acute endogenous stress. If a patient suffering chest pains tested negative at presentation for both standard cardiac troponin and copeptin, which was the case in two-thirds of all patients studied, then there was a 99% probability that the patient was not having AMI, the study found. Only in the remaining minority of patients testing positive for either marker or both, would it be necessary to go the usual route of staying in the emergency room, monitoring and retesting a few hours later.

By looking at the copeptin levels in blood as a marker of acute endogenous stress, Tobias Reichlin, M.D., and co-workers from the Department of Internal Medicine, University Hospital Basel, Switzerland, sought to determine the incremental value of copeptin for a rapid rule out of AMI. Since the onset of chest pain associated with AMI is an enormous stress for the patient, copeptin levels were highest in patients presenting very early after the onset of symptoms.