Tuesday, 3 March 2015


Hypnotherapy – Trance like Form

Hypnotherapy is a kind of complementary therapy with the use of hypnosis, which is an altered state of consciousness. Hypnosis related to hypnotherapy or hypnotic is a trance like form which involves heightened focus as well as concentration and is usually conducted with the help of a therapist along with the usage of verbal repetition and with mental images.

Whenever a person is under hypnosis, they tend to feel calm and relaxed and are open to any suggestions. It can be referred to a form of psychotherapy which is used to create a subconscious change in a person to form new responses, of thoughts, attitudes, feelings or behaviours. The person when hypnotized portrays certain unusual characteristics compared with non-hypnotized matter with notably heightened suggestibility and responsiveness.

Hypnosis could be used to gain control over any undesired behaviour or to enable a person to handle anxiety or pain and it is essential to know that though a person is open to suggestion at the time of hypnosis, one should not lose control over their behaviour. It is an effective method to handle stress and anxiety specially to reduce the anxiety and stress, prior to a medical process like in the case of breast biopsy.

Hypnosis Promoted as Treatment

For various long term conditions and in order to break certain habits, hypnosis is promoted as a means of treatment though there is no strong evidence to support its uses. However, hypnosis seems to have some effect though there is a disagreement among scientists on how it works.

Some are of the opinion that it is a relaxing technique which uses the power of suggestion, relying on the placebo effect. Studies on hypnosis have been done for other condition which include – pain control which could be beneficial for pain associated ailments of cancer, irritable bowel syndrome, headaches, temporomandibular joint problem, fibromyalgia and dental procedures. With regards to hot flashes, hypnosis could relieve the symptoms of hot flashes which could be associated with menopause or in behaviour changes where it is used with some success in the treatment of insomnia, smoking, phobias, bed-wetting and obesity.

Conducted by Health Care Profession/Trained Therapist

When hypnosis is conducted by a health care professional or a trained therapist, it is considered complementary, safe and an alternative medicine treatment though it would not be appropriate to conduct on people having severe mental conditions.

Rare adverse reactions to hypnosis could include headache, anxiety or distress, drowsiness of dizziness and creations of false memories. Care needs to be taken prior to using hypnosis for age regression in order to help one relieve the earlier events of their life and the practice is controversial with limited scientific evidence to support its use.

Hypnosis could cause strong emotions and may alter the memories or even lead to creation of false memories. No special preparation is needed to conduct hypnosis though it is a good idea to be in comfortable clothing which will enable the individual to relax and ensure that one is well rested in order to avoid falling asleep at the time of the session.

Saturday, 28 February 2015

Typhus Fever

Mass death Grave of Typhus in 1945
Typhus Fever – Rickettsia Bacteria

Typhus fever is caused by Rickettsia bacteria and transmitted by arthropod like mite, flea or tick bites. When arthropods bites a victim they tend to leave behind the rickettsaie bacteria and on scratching the bite, it opens the skin to the bacteria enabling them to enter the bloodstream and the bacteria grow and get replicated within the blood stream.

The name is derived from the Greek word typhos which means smoky or hazy and describes the state of mind of those victim affected with this condition. The organism Rickettsia is an obligate intracellular parasitic bacterium which does not survive for long outside the living cells and this condition should not be confused with typhoid fever.

Typhoid means `typhus-like’ wherein the diseases are distinct and is caused by different genera of bacteria. Different types of arthropods carry specific rickettsaie bacteria for each type of typhus and the symptoms vary slightly by type, the most common are universal which affect almost all typhus victims.

Three Types of Typhus 

Typhus is of three types – Epidemic typhus which is the most serious type, occurs in Africa, South America and Asia. Epidemic typhus is transmitted from person to person by body lice and is not the same as head lice of pubic lice, though a nuisance does not transmit disease.

The body lice get infected with Rickettsia prowazekii bacteria when they tend to feed on the blood of an infected person and if one gets infected by body lice their infected faeces will be deposited on the skin as they feed on the blood. On scratching a bite, the contaminated lice faeces get rubbed in the tiny wound on the skin and become infected. Rare cases of epidemic typhus are by breathing infected dried body louse faeces in the atmosphere.

Endemic typhus, the milder form of the condition, occurs throughout the world and is transmitted by mites, ticks and fleas that are infected with Rickettsia bacteria. These animal carriers tend to live in thick scrub vegetation or on small rodents or mammal like the rats.

Scrub typhus which is also known as Tsutsugamushi fever is transmited from mites which are infected with Orientia tsutsugamushi bacteria. They tend to live in heavy scrub vegetation in rural parts of Southeast Asia, Oceania and northern Australia.

Symptoms of Typhus 

The symptoms are somewhat similar in all the three types of Typhus wherein the person will begin to feel unwell for 10 to 14 days after getting infected. A severe headache which is sudden is often the first symptom.Other symptoms could comprise of a fever with the temperature rising above 38.9C or 102F for around 2 weeks, a feeling of nausea and vomiting, a pink or red rash which appears on the chest, spreading to the arms, hands, legs and the feet though not on the face, palms and soles.

The person may also experience abdominal pain and diarrhoea, joint and muscle pain, the most common being the backache, and cough. They may also feel mentally dazed or delirious. Treatment given is antibiotic medication in order to stop the infection and if not treated it could lead to serious complications. Prevention is better than cure and this condition can be prevented by focusing on destroying or avoiding arthropod infestations

Wednesday, 25 February 2015


Norovirus – Winter Vomiting Bug/Food Poisoning/Stomach Flu

Norovirus at times known as winter vomiting bug, is a common stomach bug in the UK. Noroviruses are group of viruses which cause inflammation of the stomach and the large intestine lining and are the main cause of gastroenteritis. The viruses are very contagious and can affect people of any age causing diarrhoea and vomiting. Originally, norovirus was known as the Norwalk virus after the town of Norwalk, Ohio which was the first confirmed outbreak location in the year 1972.

The noroviruses are also called food poisoning sometimes due to being transmitted through food which tends to get contaminated with the virus. Though they are not always the cause of food contamination, Noroviruses are also called stomach flu but they are not the influenza virus. There does not seem to be any specific cure for norovirus and it usually tends to be mild and does not last more than a couple of days.

The period from the time of infection to when the symptoms show up being the incubation period tends to last between 12 to 48 hours and the person could be infectious to others during this period. Norovirus is not usually dangerous and mostly people make a full recovery within a few days without the need of visiting their physician.

Causes & Symptoms

Individuals tend to get infected when they consume food or drink that has been contaminated, raw or undercooked oysters and raw vegetables and fruits which have been implicated during outbreaks. One could also get infected if one touch an object or a surface which has been infected with the virus and the same is touched to one’s nose, mouth or eyes.

When a person get infected from contaminated food, the virus can be passed from person to person by sharing food or vessels, by shaking of the hands through a handshake or through other close contact and those with a weak immune system are more vulnerable in catching noroviruses.

The person suffering from norovirus can undergo a drastic change from being completely healthy to feeling absolutely miserable within a day or two after being infected.The symptoms include vomiting – often among children, nausea, watery diarrhoea – often in adults and stomach cramps.

Prevention & Treatment

Noroviruses unlike other viruses does not respond to antibiotics that are meant to kill bacteria and no antiviral medicine can treat noroviruses. In healthy persons, the ailment passes off on within a few days and most of them do not have any long term problem from the virus.

To prevent the infection of norovirus, one needs to maintain good hygiene especially in the case of being surrounded with many people during an outbreak. Hands need to be washed often with soap for at least 15 seconds or a alcohol-based hand sanitizer particularly after visiting the bathroom or changing a child’s diaper and prior to the preparation or consumption of a meal.

Contaminated items should be carefully disposed, raw fruits and vegetables should be washed thoroughly, disinfect and clean surface with mixture of detergent and chlorine bleach after a person is sick, oyster and other shellfish should be well cooked etc.

A person suffering from norovirus should avoid cooking food for at least a couple of days or till they feel much better and consumption of food prepared from a person suffering from norovirus should be avoided.

Tuesday, 17 February 2015

Perforated Eardrum

Image Credit: entclinic
Perforated Eardrum – A Hole/Tear in the Eardrum

Perforated eardrum or ruptured eardrum or a tympanic membrane perforation,is a hole in the eardrum that could lead to complications like a middle ear infection and hearing loss. A ruptured eardrum is a tear in the thin membrane which separates the outer ear from the inner ear which is made up of tissues resembling skin. Sometimes it would need surgery to repair the damage to the eardrum.

It can be quite uncomfortable though it heals on its own without much treatment within two months. The functions of the eardrum is of two types wherein it senses vibrating sound waves and converts the vibration into nerve impulses conveying the sound to the brain and protects the middle ear from bacteria, water and other foreign objects.

The middle ear is normally sterile though when the eardrum tends to get ruptured, bacteria could get in the middle ear causing infections known as otitis medi. If one is suffering from perforated eardrum, their hearing could be affected and they will experience earache and any hearing loss could be temporary. If the person experiences pain and discomfort in the ear for more than a couple of days, a visit to the physician should be done for timely treatment.

Causes of Rupture

Several causes could be responsible for eardrum rupture one being the most common cause is an ear infection. This occurs when the middle ear gets infected and pressure builds up pushing against the eardrum which when it tends to be great, causes the eardrum to perforate. When this occurs, one may notice that the pain and pressure experienced earlier suddenly tends to stop and pus drains from the ear.

Another cause of ruptured eardrum could be the result of poking the eardrum with a foreign object like a cotton-tipped swab or a bobby pin used to clean the wax out of the ear canal. Children at times tend to puncture the own eardrum by putting objects like small toy or stick in their ear. Some eardrum ruptures could be the result of what is known as barotrauma which happens when the pressure in the ear and the pressure outside the ear in not balanced.

For instance, when the airplane changes altitude resulting in the air pressure in the cabin tends to drop or rise. Scuba divers also face this problem when there is a rise or fall change in pressure. Besides this, a head injury or a slap near the ear could cause the eardrum to rupture or an acoustic trauma caused by sudden loud sound, like an explosion or a sudden blast of loud music.

Symptoms & Diagnosis

The symptoms of ruptured eardrum could include drainage from the ear which may be bloody, clear or resembles pus, sudden sharp ear pain or sudden decrease in ear pain, ear noise or buzzing sound, hearing loss which may be partial or complete in the affected ear, facial weakness or dizziness and episodic ear infection.For diagnosing a ruptured eardrum the doctor will do an otoscopic examination wherein an otoscope, an instrument with a light is used to look in the ear giving the clear view of the interior of the ear.

At times there may be too much wax or drainage which may not be possible for the doctor to view the eardrum. In such a situation, he may have to clean the ear canal or prescribe eardrop to clear the same. At other times the doctor may use a rubber bulb attached to the otoscope to blow a puff of air in the ear and if the eardrum is not ruptured, it will move when the air hits it and if ruptured, it will not move.

The doctor would also test the hearing to find out how much hearing has been affected due to the ruptured eardrum by using a tuning fork to test it. An audiology test may also be conducted which is a series of tone one listens to with the headphones to determine the level of hearing.

Treating Ruptured Eardrum

Several cases of ruptured eardrum could be temporary and normal hearing returns back after the eardrum gets healed. There is no specific treatment for ruptured eardrum and mostly gets healed within a few months. Antibiotic could be prescribed which could be in oral or in the form of eardrops in order to prevent an ear infection or to treat the prevailing infection.

If the eardrum is slow in healing, the doctor could put a patch on the eardrum where in some cases a surgery would be needed to repair the ruptured eardrum. This is done through a procedure which could take a couple of hours wherein the doctor would attach a piece of one’s own tissue to the eardrum to rebuild the eardrum.

This surgery is used typically for large perforations, for perforations that would involve the edges of the eardrum or ruptured eardrum caused by ear infection. Thereafter care should be taken to ensure that the ear is kept dry in order to help in the healing process.

Sunday, 15 February 2015

West Nile virus

Image Credit: The Mississippi Link.com
West Nile Virus – Bites from Mosquitos 

West Nile encephalitis is an infection of the brain which is caused by a virus known as the West Nile Virus.People get infected with West Nile virus from the bites of mosquito which are found in several countries all across the globe and most of the cases are not serious.

The person either has no symptoms or mild flue like symptoms such as headaches, muscle aches along with high temperature. Serious problems could include infection of the brain or encephalitis, spinal cord and the tissues surrounding the brain as well as the spinal cord – meningitis which could be dangerous. Symptoms or signs of severe infection may comprise of muscle weakness, seizures or fits, disorientation and loss of consciousness.

West Nile is a virus which is capable of causing disease in humans. The symptoms include skin rash, swollen lymph glands besides the fever, headache and body aches. The severe symptoms may include stiff neck, tremors, coma, paralysis besides convulsions and disorientation.

This virus is carried from infected birds to people through the mosquitoes and there is no evidence of transmission from person to person. To reduce the risk of getting infected, the use of insect repellents could be helpful.

Diagnosis – Blood & Cerebrospinal Fluid Test

West Nile virus is found in several parts of the world which may include Africa, west and central Asia, Middle East, Southern Europe, North, Central and South America, The Caribbean and Australia. While travelling to these destination, one should wear loose fitting, long sleeved tops with long trousers which can cover the skin to avoid the mosquito bites.

The use of insect repellent on exposed skin should be maintained, insect proof screens on window and door together with nets impregnated with insecticide over the bed could be of great help and reduce mosquito bites in the interior of the dwelling place.

Care should be taken to avoid the area where there could be large number of mosquitos like areas near stagnant pools of water. Diagnosis of this condition is confirmed with a blood or cerebrospinal fluid test. If meningitis is suspected, a sample of the cerebrospinal fluid which is the fluid surrounding the brain and spinal cord is removed during a lumbar puncture and then tested.


If the symptoms tend to be severe, the person may have to be hospitalized with treatment like intravenous fluid given through a drip in the arm, medication to control seizures and aid provided for breathing. There is no specific treatment for this infection though intensive support therapy is given for the complication of brain infections with anti-inflammatory medication, intravenous fluid and close medical monitoring is done in cases which are serious.

There is no vaccine for the prevention or specific antibiotic or antidote for the viral infection. The risk of this infection is high at the time of mosquito season which does not lower till the mosquito activity ends for the season which is when the freezing temperature takes place.

Cases of West Nile virus infection takes place in temperate area especially in late summer or early fall and in southern climate where the climate tends to be mild, infection could take place all year round.

Friday, 13 February 2015

Lichen Planus

Lichen Planus – Disease of the Skin 

Lichen planus is a disease of the skin, a chronic recurrent rash which is caused due to inflammation. The rash is characterized by small, flat topped with many sided bumps which tend to grow together into rough, scaly plaques on the skin. It resembles lichen that grows on tree bark or on rocks.

The cause of this disease is not known though it is presumed to be the result of an autoimmune process with an unknown trigger. There is no cure though various medications and procedures can be used in order to control the symptoms. Lichenoid reaction or lichenoid lesion is referred to a lesion of identical or similar histopathologic and clinical appearance to lichen planus which is an area that seems the same as lichen planus to the naked eye as well as under a microscope.

At times dental materials or some medication could cause lichenoid reaction. Besides this it could also occur in association with graft versus host disease. Lichen planus can be distinguished from psoriasis, eczema and other rashes on the basis of its clinical appearance wherein the lesions are small bumps or aggregations of bumps which are flat, topped, polygonal, shiny, and purple to grey in colour and may tend to appear at the wrist, elbows and ankles. On observing closely, it may have thin white lines known as Wickham’s striae.


Lichen planus tend to itch with an intensity which may vary in different cases from mild to severe. Its onset could be sudden or gradual and the first attack could last for weeks or months with recurrences that may take place for years.

 The bumps in its initial stage are 2mm to 4mm in diameter with angular borders together with a violet colour. Excess of pigment – hyperpigmentation, may tend to develop in the affected area as the lesions persist. In rare cases, a patchy, scarring balding appears on the scalp.

Skin involvement with lichen planus comprises of flat topped lilac or violet spots of a few millimetres in diameter on the skin which appear in areas of the wrists, forearms, lower legs above the ankles as well as the lower part of the back. Variant of this disease is known as hypertrophic lichen planus. In this condition a thick, reddish brown lesion appears which are covered with scales.

These spots appear to be on the skin though they could occur on any area of the body and are itchy with persistent variant of lichen planus.


Dentists often come across a white lacy rash on the inside of the cheeks of people who may not be aware of this condition and are affected with lichen planus. They tend to have the rash inside their mouth – oral mucosa. This rash often appears prior to any skin involvement. Rare but more troublesome is erosive lichen planus which could be quite sore and uncomfortable causing the person to complain of the shallow and painfully recurrent ulcers in the mouth.

Lichen planus could also affect the female genitals.Most cases of lichen planus of the skin disappears on their own within six to nine months and the rash rarely last longer than eighteen months. If the itch or the appearance of the rash is unpleasant, topical corticosteroid creams could be helpful. In more severe cases, physician may recommend oral medications or therapy with ultraviolet light.

Wednesday, 11 February 2015

Sjögren's Syndrome

Sjogren’s Syndrome – Chronic Autoimmune Disorder

Sjogren’s syndrome is a chronic autoimmune disorder in which a person’s immune system attacks glands that secrete fluid like the tear and saliva glands. The white blood cells attack moisture-producing glands which make it difficult for the body to produce saliva and tears. Certain glands could tend to get inflamed thereby reducing the production of tears and saliva causing the main symptoms of Sjogren’s syndrome which are dry mouth and dry eyes.

Its effect could be widespread. Sjogren’s syndrome is an autoimmune condition, wherein instead of protecting the body from illness and infection, the immune system reacts abnormally and attacks the healthy cells and tissues. The immune system attacks the other secretory glands in the body, besides the tear and saliva glands.The cause of this disorder is not known, though researchers are of the opinion that it is triggered by a combination of genetic, environment and probably hormonal factors. Some people are prone to be more vulnerable to this ailment when they are born and certain events like an infection could trigger the problems with their immune system.

Primary SS/Secondary SS

Sjogren being a systemic disease could affect the entire body and is not localized to one area and its symptoms could remain steady or worsen or go into remission. Some may experience a mild discomfort and have a normal life while others could suffer from debilitating symptoms which could severely affect their daily routine activities. Diagnosing the condition in its initial stage with timely treatment could help to prevent serious complications and lead to improvement of the disease.

At times this disorder occurs alone while at other times it could occur in the presence of another autoimmune connective tissue disease like rheumatoid arthritis, lupus, or scleroderma that are often linked with Sjogren’s. Whenever one or more autoimmune disorders take place simultaneously, they are known as overlap diseases and when it occurs alone, Sjogren’s syndrome is called primary Sjogren’s syndrome (Primary SS). When it tends to occur with another connective tissue disease it is said to be secondary Sjogren’s syndrome (Secondary SS).

Signs & Symptoms 

Those suffering from secondary Sjogren’s have a milder condition though they could deal with symptoms of the co-existing or overlap disease, the most common condition taking place with secondary Sjogren’s is rheumatoid arthritis. Signs and symptoms of this condition may differ from person to person, from extreme fatigue and joint pain to dysfunction in main organs like the kidneys, circulatory system, lungs, gastrointestinal system, liver, pancreas and the central nervous system where the most pronounced symptoms are dry eyes, dry mouth and throat.

Common oral symptom is xerostomia or dryness of the mouth – burning or cracking of the tongue, need for lubrication while speaking, cracked or peeling lips, intensified dental decay – cavities or root decay, painful swelling of salivary glands. There is no treatment for Sjogren’s syndrome but treating this condition could help to reduce the symptoms. Dry eyes and mouth could usually help with the aid of artificial saliva and tears. It is essential to maintain good eye and mouth hygiene since the risk of developing the infection could be greater. Maintenance of good hygiene of eyes and mouth could help to avert the problem like corneal ulcers as well as tooth decay.

Other Symptoms

Symptoms which may develop in the throat and nose include difficulty in swallowing, limited ability in taste and/or smell coughing and dry nose. The most prominent symptom around the eyes is a sandy or gritty sensation together with limited potential to produce tears, constant itching, redness and burning, decrease in mucus leading to coughing with irritation in the throat, photosensitivity, and difficulty in swallowing with irritation in the stomach.

In rare cases, Sjogren’s could cause symptoms outside the glands, like skin rash, gastrointestinal problems or inflammation of the liver, pancreas, kidneys or lungs and these symptoms are seen in 1/3 of people with primary Sjogren’s though rarely with secondary Sjogren’s. The extra glandular symptoms include muscle pain, joint pain, low-grade fevers and increased fatigue.There is a possibility that some of these symptoms and signs could be associated with lung, kidney, and or vasculitis (inflammation of blood vessels) involvement. There is also the possibility of experiencing lymphomas – tumours of the lymph glands, which tend to develop in 6% of cases with primary Sjogren’s.


Just in the case of lupus, there is no single definite test for Sjogren’s and diagnosis usually takes place when a person with a diagnosed autoimmune disease tends to experience extreme dryness of the mouth and eyes. The diagnosis involves a complete medical history together with a physical examination of the individual. It takes around 4-7 years to receive a diagnosis since the disease is usually mild and the first signs of dryness in the mucous membrane could be present for years before the disease is eventually diagnosed. The test carried out to confirm the diagnosis includes:

Schirmir’s Test: where a piece of paper is placed at the corner of the eye to determine the degree of wetting over a period of 5 minutes.

Salivary Gland Flow Rate Test: determines if there is a decrease in the production of saliva.

Rose-Bengal Staining Test: test determines the cornea is inflamed or not.

Biopsy: the lip or the parotid gland which is the gland producing saliva could be biopsied to determine the diagnosis