Wednesday, 1 April 2015

Monkeypox


Monkeypox
Credit:discovermagazine.com
Monkeypox – Rate Viral Disease

Monkeypox is a rare type of viral disease caused by the monkeypox virus and the disease was first discovered in laboratory monkeys though in its natural state it tends to infect rodent more than the monkeys. The disease mostly occurs in central and western Africa and an outbreak which took place in the United States in 2003 was due to a pet store which sold imported Gambian pouched rats.

Monkey pox virus is a zoonotic viral disease which takes place especially in remote villages of Central and West Africa in the vicinity to tropical rainforests where thereis more contact of infected animals and is usually transmitted to humans from rodents’ pets and through contact with the blood of the animal or through bites.

The disease can spread from person to person through huge respiratory droplets at the time of long periods of face to face contact or on touching body fluids of an infected person or the objects like the bed linen, clothing which could be contaminated with the virus.

It is difficult to differentiate monkeypox clinically from smallpox and chickenpox. It was found that other types of animals probably had monkeypox, from the blood test of animals done later in Africa. In humans, it was for the first time in 1970, that monkeypox was reported. Monkeypox virus belongs to a group of viruses which includes smallpox virus.

Signs and Symptoms of Monkeypox

The signs and symptoms of monkeypox in humans are similar to those of smallpox though they are usually milder. The difference is that it causes the lymph nodes to swell. For around 12 days after the person is infected with the virus, they tend to get fever, headache, muscle aches and backache and their lymph nodes starts swelling with a feeling of tiredness.

Between the first and third day or longer, after the fever comes in, they tend to get a rash which develops into raised bumps filled with fluid and tend to begin on the face spreading to other areas, though it could begin on other areas too. Before the bumps gets crusty and the scabs fall off, they go through several stages and the illness last for 2 to 4 weeks.

For treating monkeypox, a smallpox vaccination should be administered within a period of two weeks of exposure to monkeypox and an antiviral drug is recommended for patients with severe or life threatening symptoms

Prevention of the Disease

This disease can be prevented by refraining from eating or touching animals that are prone to the virus and those who are infected with this disease need to be physically isolated till the pox lesion are healed.

Those who tend to care for these people should use protective measures like using gloves and face masks to avoid any direct or droplet contact with the patient and should also obtain a smallpox vaccination. Since smallpox and monkeypox are quite similar, studies carried out indicate that people who have been vaccinated against smallpox have about 85% chances of being protected against monkeypox. There is no commercially designed vaccine available for monkeypox. The CDC has recommended the following:

  • People who have depressed immune systems and are allergic to latex or smallpox vaccine should not take the smallpox vaccine. 
  • Those who have been exposed to monkeypox in the last 14 days should take the smallpox vaccine which also includes children below one year of age; pregnant women as well as people having skin conditions.

Monday, 30 March 2015

Mucositis


Mucositis
Image Credit:misc.medscape.com
Mucositis – Side Effects of Chemotherapy

Mucositis is a common side effect of chemotherapy and is also at times caused by radiotherapy when it involves the head or the neck. It takes place when the cancer treatment breaks down the rapidly divided epithelial cells that line up the gastro-intestinal tract, leaving the mucosal tissue open to ulceration and infection.

The mucosal tissue is also known as mucosa or the mucous membrane and is what lines all body passages communicating with the air like the respiratory and alimentary tracts having cells which associate with glands secreting mucus. The section of the lining covering the mouth is the oral mucosa and is one of the most sensitive areas of the body. It is also vulnerable to chemotherapy and radiation and the oral cavity is one of the most common sites for mucositis.

Mucositis is divided into two main types which include oral mucositis and gastrointestinal mucositis. Oral mucositis can cause mouth ulcers or sores with pain or difficulty in swallowing while gastrointestinal mucositis occurs in the digestive system, often causing diarrhoea. There is also a possibility for mucositis affecting the lining of the anus which is a condition known as proctitis.

Symptoms

Oral mucositis is the most, unbearable complication of cancer treatments especially chemotherapy and radiation leading to many problems which includes pain, nutritional issues resulting in inability to eat with increased risk of infection due to open sores in the mucosa.

This has a significant stress on the patient’s quality of life. Individuals that receive radiotherapy for cancer treatment like breast cancer may not develop mucositis since the therapy is not focused near the mucous membranes. The digestive tract tends to be more vulnerable to the harmful effects of radiotherapy or chemotherapy which could damage the delicate lining and if they have to undergo cancer treatment which could cause mucositis, a regular check for the condition is done.

 Mucositis usually is diagnosed after an examination or checking on the symptoms. It is considered that around 40% of the people who tend to receive chemotherapy as cancer treatment may develop some degree of mucositis and it can be more severe in a few cases based on the treatment.

Treatment

Around 70% of the people who receive high doses of chemotherapy due to stem cell transplant or bone marrow transplant tend to develop mucositis. Treatment for mucositis is to prevent the infection and reduce the pain which is done with the use of painkillers together with good oral hygiene. Other treatments are available to reduce the symptoms of oral mucositis like low-level laser therapy – LLLT and medication while for gastrointestinal mucositis to reduce the main symptoms of the condition like diarrhoea and inflammation, a combination of medicine and self-care measures is essential.

The symptoms of this condition tend to improve after a few weeks on completion of the radiotherapy and chemotherapy though it could take longer. Most of the serious cases could lead to a number of other health conditions and some people with mucositis find difficulty in swallowing food and the need of alternative feeding method like feeding tube may be needed. Mouth ulcers could get infected with bacteria which could spread to the blood and to the other organs which is known as sepsis and could be dangerous to life.

Saturday, 28 March 2015

Hemochromatosis


Hemochromatosis
Hemochromatosis – Inherited Condition with Excessive Iron 

Hemochromatosis is an inherited condition wherein excessive accumulation of iron in the body or an overload arises. Those affected with hereditary hemochromatosis may have no signs or symptoms or could have severe symptoms and signs of iron overload which could include heart failure, pain in the joints, cirrhosis of the liver, diabetes, fatigue as well as darkening of the skin. It is a common genetic disorder among Caucasian in United States and could affect around 1 to 6 individuals in United States.

The body’s normal iron content is three to four grams and the total content of iron in the body is controlled carefully wherein the body tends to lose daily, one mg of iron from sweat and cells that are shed from the skin and the inner line of the intestines. In adults the intestines absorb one mg of iron from food to replace the lost iron, daily and hence there is no excess of iron in the body and when the loss of iron is greater, more iron is absorbed from food. For those with hereditary hemochromatosis, daily absorption from the intestines of iron is greater than the amount needed to make up for the losses. When the normal body is not capable of increasing iron excretion, the absorbed iron tends to accumulate in the body.

Signs and Symptoms 

A person with hemochromatosis at this rate could accumulate 20 grams of total body iron at the age of 40 to 50 and this excess deposit of iron settles in joints, liver, heart, resulting in damage to the organs with signs and symptoms of hemochromatosis.

Women suffering from hemochromatosis tend to accumulate iron at a slower pace than men since they lose more iron then men during menstruation and breastfeeding. During the initial stage of hemochromatosis there are no symptoms and most of them are unaware of the condition and it is only suspected when high level of iron blood is noted through routine blood test. Some signs and symptoms may include

  • In men, the symptoms may not show up till the age of 30-50 years. The iron deposits in the skin and the skin appears dark and since women tend to lose iron through menstrual blood loss, non-menstruating women may develop symptoms 15 to 20 year later.
  • Iron deposits in the pancreas may lead to a decrease in insulin production causing diabetes
  • Iron deposits in the heart muscle could cause cardiomyopathy leading to heart failure and abnormal heart rhythms
  • Iron accumulated in the liver could lead to scarring of the liver or cirrhosis with an increased risk of developing liver cancer.
Diagnosis – Between 30 – 50 

Diagnosis is done between the age of 30 and 50 where 75% show no symptoms. This condition is only discovered when elevated levels of iron in the blood are found at the time of routine blood test or when blood iron levels are measured in screening studies in family members of patients with this condition.

Others are diagnosed as part of the evaluation for abnormal elevation in blood levels of liver enzymes, AST and ALT though the symptoms of skin bronzing or hyperpigmentation, liver disease, diabetes, arthropathy, hypogonadism and cardiomyopathy may be present and are recommended with additional screening test like transfer in saturation and other liver and blood test.

Effective treatment for hemochromatosis is to reduce the iron content in the body by phlebotomy. Diagnosing hemochromatosis early with timely treatment could prevent damage to the liver, heart pancreas, joints and the person can maintain a normal health.

Wednesday, 25 March 2015

Meningococcal Disease


Meningococcal
Meningococcal Meningitis – Bacterial Form of Meningitis

Meningococcal meningitis is a kind of bacterial form of meningitis which is a serious infection of the meninges that can affect the brain membrane. The person tends to suffer from severe brain damage which is fatal in most cases if not treated in time.

Various types of bacteria could cause meningitis and Neisseria meningitidis is one kind which has the potential of causing a large epidemic. Twelve types of sero-groups of N meningitidis which have been identified out of which 6 – A, B, C, D, W; X and Y could cause epidemics. The epidemic potential and the geographical distribution may vary according to sero-group.Being a rare and serious infection, it causes the inflammation of the membrane covering the brain and the spinal cord.

If prompt treatment is not rendered it could be fatal or cause some serious harm. As per the Centres for Disease Control around 15% of those who tend to survive, have some disabilities which includes deafness, brain damage and neurological problem. The two cause of meningitis are bacteria and virus and the bacterium Neisseria meningitidis also known as meningococcus causes meningococcal meningitis. It is very common cause of bacterial meningitis in children and teenagers. In the case of adults it is the second most common cause.

Causes & Symptoms

The meningococcal bacteria could cause infection in a part of the body such as the skin, gastrointestinal tract or the respiratory tract. The bacteria for some unknown reasons could spread through the bloodstream to the nervous system and then causes meningococcal meningitis. The bacteria also tend to enter the nervous system directly after severe head trauma, infection of surgery.

 If the person is exposed to the bacterium which is the cause, or if they have had a recent upper respiratory infection, then the risk of the ailment increases. Toddlers, children as well as teens are also at great risk.

Symptoms of meningococcal meningitis may differ from person to person and the most common symptoms comprise of stiff neck, high fever, sensitivity to light, severe persistent headaches, nausea and vomiting, confusion, joint pain and general poor feeling. Around 5 to 10% of the patients die typically with 24 to 48 hours after the symptoms show up, even when the condition is diagnosed in its initial stage with adequate treatment rendered.

Precaution – Prevention 

A less common though severe form of meningococcal is meningococcal septicaemia that is characterized by a haemorrhagic rash together with rapid circulatory collapse. Reddish or a purple skin rash is a sign to look for in the case of this ailment and if it does not turn white when you press a glass against it, the rash could be a sign of blood poisoning and is a medical emergency.

Once the diagnosis of the condition has been confirmed, the doctor could start with antibiotics by an IV or intravenous line. The person could also need other medication to treat issues related to increased spinal fluid pressure where at times steroids could be prescribed. Antibiotics should be given to prevent infection when in contact with a person suffering from meningococcal meningitis either through their saliva, or any other oral secretions. Precautions should be taken as it important for prevention as the saying goes: `Precaution is better than a Cure’.

Monday, 23 March 2015

Psittacosis


Psittacosis
Psittacosis – Parrot Fever- Zoonotic Infectious Disease

Psittacosis which is also known as parrot fever and ornithosis, is a zoonotic infectious disease and is caused by a bacterium known as Chlamydia psittaci which is contracted from parrots like budgerigars, cockatiels and macaws and pigeons, sparrows, ducks, hens, gulls and several other species of bird. In some context, the term `pssitacosis’ is used when the disease is transmitted by any species of bird of the Pssitacidae family while `ornithosis’ is used when the other birds are the carriers of the disease.

This ailment is a very rare form of disease and according to the Centres for Disease Control and Prevention, less than 50 confirmed cases per year have been known in the United States since 1996 though several cases could have gone undiagnosed or unreported. A person can suffer from parrot fever from an infected bird in many ways such as by handling the bird or breathing in the fine particles of its faeces or other bodily excretions that could lead to an infection or may also become infected if the person is bit by the bird or one tends to kiss the bird by touching their mouth to their beak.

Symptoms

The symptoms of parrot fever resembles flu or pneumonia and begins around ten days after exposure though would take less or around 19 days for the symptoms to show up and most of the symptoms associated with flu include -


• Fever with the combination of chills
• Nausea and vomiting
• Diarrhoea
• Muscle and joint pain
• Weakness
• Fatigue
• Cough which would be typically dry

Other symptoms which may not seem like flu comprises of chest pain, intolerance to light and shortness of breath and in rare cases the infection could also cause inflammation of various internal organs which may include the brain, liver and areas of the heart. Moreover it could also lead to decreased lung function leading to pneumonia. Since this disease is a rare condition, doctors often tend to overlook the disease at first and hence it is advisable to inform the physician if one has been exposed to any potentially sick bird or have been working in a pet shop, veterinarian’s office, poultry processing plant or any area which is exposed to birds.

Diagnosis & Treatment

Diagnosis of the condition is done through several tests where the blood and sputum could reveal if one has the type of bacteria causing the infection. X ray of the chest or CT scan could show if there are traces of pneumonia which is sometimes caused by the disease. The physician could also order an antibody titer test to detect if there are any antibodies to the bacteria causing the parrot fever and how much of the antibody are present.

Antibodies are proteins that the immune system produces when faced with a foreign, harmful or antigens substance like parasites or bacteria and the changes in level of antibodies could indicate how much the person has been infected with the bacteria,Chlamydia psittaci, causing parrot fever. Parrot fever is treated with the help of antibiotics which are effective against this disease and with timely treatment the person can be restored to normal health.

Friday, 20 March 2015

Chronic Obstructive Pulmonary Disease


COPD
Chronic Obstructive Pulmonary Disease – Group of Lung Diseases

Chronic obstructive pulmonary disease COPD is referred to a group lung diseases which tend to block the airflow making the breathing difficult. It is the name given for a collection of lung ailments which include chronic bronchitis, emphysema and chronic obstructive airways disease. People suffering from COPD have breathing problems which is due to the narrowing of their airways known as airflow obstruction. The symptoms include, increasing breathlessness while they are active, frequent chest infection, persistent cough with phlegm and the main cause of this ailment is smoking.

The chances of developing this disease increases on smoking and the length of smoking period. Smoking tends to cause irritation and inflames the lungs which results in scarring and over a period of time, the inflammation leads to permanent changes in the lungs. The walls of the airways tend to get thicken with the development of more mucus. The delicate walls of the air sacs in the lungs get damaged causing emphysema with the lungs losing their normal elasticity while the smaller airways become scarred and narrowed. All these changes result in the symptoms of breathlessness, cough and phlegm which are associated with this disease. There are other cases of this disease which is due to dust, air pollution, fumes and genetic disorders though they are quite rare.

Common Conditions - COPD

Emphysema and chronic bronchitis are considered the two most common conditions which are responsible for COPD. Chronic bronchitis is the inflammation of the lining of bronchial tubes that carries air to and from the lungs and emphysema takes place when the air sacs or alveoli towards the end of the smallest air passage, bronchioles, in the lungs tends to get destroyed gradually. Damage to the lungs due to COPD cannot be changed or reversed though treatment could be helpful in controlling symptoms which could reduce further damage. The symptom of this disease does not often show up till the damage has occurred to the lungs which usually worsen over a period of time. In the case of chronic bronchitis, the main symptom is cough which one tends to have at least three months in a year for two consecutive years while the other signs and symptoms may include:
  • Shortness of breath which is more pronounced during physical activities
  • Wheezing
  • Chest tightness
  • The need to clear the throat first thing in the morning due to excess mucus in the lungs
  • A chronic cough which produces sputum which may be clear, white, yellow or greenish
  • Lack of energy
  • Change in colour of blueness of the lips or fingernail beds
  • Frequent respiratory infections
  • Unintended loss of weight which could occur at a later stage
Test & Treatment 

The following test are done for those suffering from COPD which include –

Pulmonary function test – Spirometry being the most common lung function test wherein at the time of this test the person needs to blow into a large tube which is connected to a spirometer and the machine measures how much air the lungs can hold and how fast one can blow out the air from the lungs. It can detect the disease much prior to the symptoms of the ailment and can also be used to track the progress of the disease as well as monitor on the treatment.

Chest X-ray can portray emphysema which is one of the main causes of COPD and can also identify other lung problems or heart failure if any.

CT scan of the lungs could help in detecting emphysema and determine if one would need a surgery for the ailment and could also be used to check for lung cancer which is also common among individuals suffering from COPD.

Arterial blood gas analysis is a blood rest which measures how well the lungs are bringing oxygen in the blood and leaving carbon dioxide.

Medication

For all stage of disease, effective therapy available could control the symptoms and reduce the risk of any complications and help in leading an active life. The essential step in the case of COPD is to quit smoking and reduce the chances of getting worse. Doctors may recommend several types of medication to treat the symptoms of COPD which could be taken on regular basis or as the need arises. There are medications which come in the form of inhaler which tends to relax the muscles around the airways and also relieves cough and shortness of breath, making breathing easier.

Inhaled medications could reduce airway inflammation which could help in prevention of exacerbations. Some side effect could include oral infections, bruising and hoarseness. Oral steroids is given to those with moderate or severe acute exacerbation which prevents further worsening of the disease though these medication could tend to have serious side effect like weight gain, diabetes, cataracts, osteoporosis as well as an increased risk of infection. Antibiotic is also given which fights acute exacerbations though it is not clear whether it is due to its antibiotic effect or the anti-inflammatory properties. Surgery is also another option for some people suffering from COPD.

Friday, 13 March 2015

Ocular Migraine


Eye
Ocular Migraine – Temporary Vision Loss/Migraine Headache

Ocular migraine also known as retinal migraine or visual migraine causes vision loss or blindness which could last less than an hour together with or following a migraine headache. It causes brief attacks of blindness or visual problem such as flashing lights in one eye. It is a retinal disease accompanied by migraine headache affecting only one eye and is caused by an infract or vascular spasm in or behind the eye which is affected.

These instances could be alarming though in most of the cases they are harmless and short-lived and the eyes gets back to normal after sometime. Terms like `retinal migraine’ and `ocular migraine’ are very often mixed up with an abnormal condition in the brain – cortical spreading depression which could cause similar symptoms like scintillating scotoma which may affect the vision of both the eyes and could also be associated with migraine headaches.

Some may get a retinal migraine every few months but the frequency could vary. The symptoms according to the International Headache Society defined as retinal migraine comprises of vision problems affecting one eye such as flashing lights, blindness in the eye and blind spots in the field of vision. The vision loss could be a complication of retinal migraines.

Symptoms 

Headaches which tends to last from 4 to 72 hours could affect one side of the head, which could be felt moderately or could be painful, pulsate in intensity and feel worse when active, physically. Besides these, other symptoms could also include, nausea, vomiting, with unusual sensitivity to sound and light.Several people tend to have a problem in identifying the difference between blindness in one side of their vision or flashing lights though it involves both eyes but these symptoms are only in one eye.

 Regular migraine with an aura which could involve flashing lights and blind spots in vision seems to be a common problem which affects around 20% with migraine though in these cases the symptoms tend to appear usually in one side of their field of vision and in both eyes. Checking with each eye separately could give an understanding on the condition, affecting one eye or both.

Causes of Ocular Migraine

The cause of ocular migraine is not known though some are of the opinion that the problem could be related to spasms in blood vessels in the retina, the delicate lining in the back of the eye or changes that could spread across the nerve cells in the retina. Individual who tend to have these migraines could be at higher risk of developing permanent vision loss in one eye.

Retinal migraine could be triggered by smoking, high blood pressure, stress, hormonal birth control pills, bending over, exercise, dehydration, low blood sugar and excessive heat. After a while the blood vessels tend to relax and the blood flow resumes with the eyesight returning back to normal. There are no abnormalities usually within the eye and permanent damage to the eye is very rare.

Treating this condition involves taking pain relief for headaches as well as refraining from exposure to things which could trigger the retinal migraine. Other medications could also be administered if considered necessary by the physician.