February 8, 2017

Shingles, also known as Herpes Zoaster, is a localized, painful rash caused by reactivation of the varicella zoster virus (VZV) which also causes chickenpox. The virus remains hidden in the body after chickenpox infection for many years and reoccurs later as shingles. Approximately 30% of all people who have been infected with chickenpox will later develop shingles.

A shingles rash usually appears on one side of the face or body and lasts from 2 to 4 weeks. Its main symptom is pain, which can be quite severe. Other symptoms of shingles can include fever, headache, chills and upset stomach. Very rarely, a shingles infection can lead to pneumonia, hearing problems, blindness, brain inflammation (encephalitis) or death.

Shingles is very common. Fifty percent of all Americans will have had shingles by the time they are 80. While shingles occurs in people of all ages, it is most common in 60- to 80-year-olds. In fact, one out of every three people 60 years or older will get shingles.

Shingles can occur at any age, but is most common in people who are over 50 years of age. Among people who are over 80 years of age, about 11 people in every 1,000 have shingles each year. Shingles is much less common in children.

Shingles is not spread from person to person. However, the blister fluid from the shingles rash is infectious and contact with the blister fluid can cause chickenpox in a person who has not previously had chickenpox. Shingles is less contagious than chickenpox and the risk of a person with shingles spreading the virus is low if the rash is covered.

Causes

The virus that causes chickenpox also causes shingles. After a person gets rid of the chickenpox, the virus stays in the body. The virus travels to the nerves where it sleeps. Shingles appears when the virus wakes up. It is not clear what reactivates or “wakes up” the virus. A short-term weakness in immunity may cause this.

Shingles is much less contagious than chickenpox. But a person with shingles can still spread the virus. Anyone who has not had chickenpox can get this virus.

If the virus spreads to someone who has not had it, the person will get chickenpox — not shingles. Newborns and those with a weak immune system have the highest risk of getting the virus from someone who has shingles.

This virus spreads when the person has uncovered, open blisters and someone touches the blisters. Once the blisters form scabs, the person is no longer contagious.

Who is at risk?

Some people who have had chickenpox have a higher risk of getting shingles. These people –

  • Are 50 years of age or older.
  • Have an illness or injury.
  • Are under great stress.
  • Have a weakened immune system.

Some illnesses and medical treatments can weaken a person’s immune system and increase the risk. These include –

  • Cancer.
  • HIV/AIDS.
  • Some cancer treatments, such as chemotherapy or radiation.
  • Medicine taken to prevent rejection of a transplanted organ.
  • Cortisone when taken for a long time.

Symptoms

Shingles tends to cause more pain and less itching than chickenpox. Common signs and symptoms are –

The warning – An area of skin may burn, itch, tingle, or feel very sensitive. This usually occurs in a small area on 1 side of the body. These symptoms can come and go or be constant. Most people experience this for 1 to 3 days. It can last longer.

Rash – A rash then appears in the same area.

Blisters – The rash soon turns into groups of clear blisters. The blisters turn yellow or bloody before they crust over (scab) and heal. The blisters tend to last 2 to 3 weeks.

Pain – It is uncommon to have blisters without pain. Often the pain is bad enough for a doctor to prescribe painkillers. Once the blisters heal, the pain tends to lessen. The pain can last for months after the blisters clear.

Flu-like symptoms – The person may get a fever or headache with the rash.

Complications

  • Scarring
  • Secondary bacterial skin infection
  • Nerve complications such as nerve palsies
  • Pneumonia
  • Eye damage where the ophthalmic nerve has been affected.
  • Ramsay Hunt syndrome if shingles affects the nerves of the face or ear

Treatment

It is best to get treatment immediately. Treatment can include –

Pain relievers to help ease the pain – The pain can be very bad, and prescription painkillers may be necessary.

Anti-viral medicine – This medicine may be prescribed when a doctor diagnoses shingles within 72 hours of the rash first appearing. The earlier anti-viral treatment is started, the better it works. Anti-viral medicines include famciclovir, valacyclovir, and acyclovir. These can lessen the pain and the amount of time the pain lasts.

Nerve blocks – Given for intense pain, these injections (shots) contain a numbing anesthetic and sometimes a corticosteroid.

Corticosteroids – To lower swelling and pain, some patients may get corticosteroid pills with their anti-viral medicine. This treatment is not common because it can make the rash spread.

Treatments for pain after the rash clears – Certain anti-depressants, pain relievers, anesthetic creams and patches, and anti-seizure medicines can help.

Alternative Treatment

Rhus toxicodendron (Rhus tox) is useful when blisters emerge that are not only painful but very itchy, and warmth brings relief. The pain is worse at night and less noticeable when moving about.

Arsenicum album is indicated for shingles with red, burning lesions that are relieved by warmth and are worse at night, causing great restless anxiety.

Mezereum is indicated if there is severe pain, if the skin burns and itches and forms brown scabs, or if the is person middle-aged or elderly. Lasting neuralgic pains that shoot along the nerve after the skin has healed are often helped by this remedy.

Ranunculus is useful if there are nerve pains and itching, or the slightest touch, movement or eating makes the symptoms worse.

Lachesis is prescribed if the left side of the body is affected, plus some swelling, which is aggravated by wan-nth but is relieved by cold.

Apis is used when the swelling and stinging pains predominate, improve with cold and become aggravated by heat.

Adenosine monophosphate (AMP) – The study used injections of AMP, so researchers don’t know if taking AMP orally would have any effect. People who take dipyridamole (Persatine) or carbamazepine (Tegretol) should not take AMP.

Vitamins B-12 and E – A few studies suggest that vitamin E (1,200 to 1,600 mg per day) and injections of B-12 (but not oral B-12) might help reduce symptoms of postherpetic neuralgia.

Cayenne – Capsaicin cream made from cayenne pepper can relieve pain when applied to the skin. Capsaicin may help relieve the pain of post-herpetic neuralgia, and an over-the-counter ointment is approved for this treatment.

Licorice – Traditionally, licorice gel has been used topically (applied to the skin) to treat shingles and postherpetic neuralgia. In test tubes, one of the constituents of licorice, called glycyrrhizin, stops the varicella zoster virus from reproducing.

 

Reference –

http://www.medicinenet.com/shingles_herpes_zoster/page4.htm#what_is_the_treatment_for_shingles

https://www.nia.nih.gov/health/publication/shingles

https://www.aad.org/dermatology-a-to-z/diseases-and-treatments/q—t/shingles/who-gets-causes

http://www.nhs.uk/Conditions/Shingles/Pages/Symptoms.aspx

www.shinglesaware.co.uk

 

Posted in INFECTIOUS
February 8, 2017

Postherpetic neuralgia (PHN) can be an unfortunate result of herpes zoster infection (shingles). It is defined broadly as any pain that remains after healing of herpes zoster lesions or rash, usually after a three month period.

Shingles (also known as herpes zoster) is a skin rash that can be very painful. It is a viral infection of the nerves, and the nerves affected by shingles can occasionally continue to cause severe pain after the shingles have cleared. Shingles appear as a rash, patch, or a line of painful blisters which arise on the skin over a nerve in the shape of a band. This band follows the distribution of a specific nerve where the virus has been living before its spread to the skin. Shingles affects both men and women equally. This disease is caused by the same virus that causes chicken pox (varicella zoster). Chicken pox usually affects young children, and its symptoms involve itchy blisters all over the body. Once these symptoms go away, the varicella zoster virus stays in the nerves near the spine. It is almost as if the virus “goes to sleep”. It will “wake up”, however, when the body’s immune system is

If the pain caused by shingles continues after the shingles is over – within two to four weeks – it is known as post-herpetic neuralgia. It is estimated that about one-in-five patients with shingles will go on to have post-herpetic neuralgia. Post-herpetic neuralgia (PHN) is more common as people get older – it is uncommon in children weakened. The virus then grows in the nerves, causing pain. When the virus reaches the skin, it causes the shingles rash.

Each year approximately 1,000,000 people in the U.S. develop shingles or herpes zoster. Of these, it is estimated approximately 10-20% (about 200,000) will go on to develop PHN.

The risk of developing PHN increases with age and can affect at least 40% of all herpes zoster patients over age 50 and 75% of herpes zoster patients over age 75. PHN is the single most common neurologic condition in elderly patients

Causes

The nerve damage caused by shingles disrupts the proper functioning of the nerve. The faulty nerve becomes confused and sends random, chaotic (uncontrolled) pain signals to the brain, which the patient feels as a throbbing, burning pain along the nerve.

Experts believe that shingles results in scar tissue forming next to nerves and pressing on them, causing them to send inaccurate signals, many of which are pain signals to the brain. However, nobody is really sure why some shingles patients go on to develop postherpetic neuralgia.

Symptoms

Symptoms are usually limited to the area of skin where the shingles outbreak first occurred. Symptoms may include:

  • Occasional sharp burning, shooting, jabbing pain
  • Constant burning, throbbing, or aching pain
  • Extreme sensitivity to touch
  • Extreme sensitivity to temperature change
  • Itching
  • Numbness
  • Headaches

In rare cases, if the nerve also controls muscle movement, the patient may experience muscle weakness or paralysis.

Some patients may find the symptoms interfere with their ability to carry out some daily activities, such as bathing or dressing. Postherpetic neuralgia may also cause fatigue and sleeping difficulties.

Treatment

Treatment will depend on the type of pain, as well as some aspects of the patient’s physical, neurological and mental health.

Antidepressants – These help patients with postherpetic neuralgia not because the patient is depressed, but because they affect key brain chemicals, such as serotonin and norepinephrine, which influence not only depression, but also how the body interprets pain. Dosages for postherpetic neuralgia will tend to be lower than for depression, unless the patient has both depression and postherpetic neuralgia. Examples of drugs that inhibit the reuptake of serotonin or norepinephrine are tricyclic antidepressants, such as amitriptyline, desipramine (Norpramin), nortriptyline (Pamelor) and duloxetine (Cymbalta). They will not get rid of the pain, but are said to make it more bearable.

Anticonvulsants – As with trigeminal neuralgia pain, postherpetic pain can be lessened with anticonvulsants, because they are effective calming down nerve impulses and stabilize abnormal electrical activity in the nervous system caused by injured nerves. Gabapentin (Neurontin), pregabalin (Lyrica) are examples of commonly prescribed anticonvulsants for this type of pain.

Steroids – A corticosteroid medication is injected into the area around the spinal cord. Injected steroids are effective for postherpetic neuralgia patients with chronic pain (persistent long-term pain). The patient should not receive this medication until the shingles pustular skin rash has completely disappeared.

Painkillers – This may include tramadol (Ultram) or oxycodone (OxyContin). There is a small risk of dependency.

TENS (transcutaneous electrical nerve stimulation) – Electrodes are placed over the areas where pain occurs. Small electrical impulses are emitted. The patient turns the TENS device on and off as required. Some patients obtain significant pain relief from TENS, while others don’t. Experts are not sure why the electrical impulses relieve pain. Some say that TENS stimulates endorphin release – endorphins are the body’s natural painkillers; some people call them natural “feel good” chemicals.

Spinal cord or peripheral nerve stimulation – Similar to TENS, but here the devices are implanted under the skin, along the course of peripheral nerves. These devices are a safe, efficient, and effective way to relieve many types of neuropathic pain conditions, including trigeminal neuralgia.

Alternative Treatment

Proteolytic Enzymes – Proteolytic enzymes are enzymes that are produced naturally by the pancreas to help digest protein we eat. They help in pain relief and skin improvement.

Capsaicin Cream – Although people may not have heard of capsaicin before, if you’ve ever eaten a chili pepper and felt the mouth burn. Capsaicin is the active ingredient in chili peppers and is sometimes used for postherpetic neuralgia.

Colloidal silver is an extremely effective pathogen destroyer which can be taken internally as well as applied topically. Colloidal silver attaches itself to viruses and prevents them from replicating and there are specific silver receptors on human nerve tissue – the location where the shingles virus “hides out”.

 

Reference –

http://www.centerforhomeopathy.com/shingles-post-herpetic-neuralgia/

http://emedicine.medscape.com/article/1143066-treatment

http://www.nhs.uk/Conditions/postherpetic-neuralgia/Pages/Treatment.aspx

http://www.healingchronicpain.org/neuralgia/frequency

http://www.med.or.jp/english/pdf/2004_11/529_536.pdf

http://patient.info/health/postherpetic-neuralgia-leaflet

http://www.medicalnewstoday.com/articles/160253.php

http://www.nhs.uk/conditions/postherpetic-neuralgia/Pages/Introduction.aspx

http://emedicine.medscape.com/article/1143066-overview

 

Posted in INFECTIOUS
February 8, 2017

Pelvic inflammatory disease (PID) is an infection induced inflammation of a woman’s pelvic organs. The pelvic organs include the uterus (womb), fallopian tubes, ovaries, and cervix. It is a complication often caused by some STDs, like Chlamydia and gonorrhea. Other infections that are not sexually transmitted can also cause PID. Other bacteria that normally live in the vagina can also cause it, especially after a termination of pregnancy, or having intra uterine device (IUD/coil) fitted.

In PID, inflammation spreads from the vagina or cervix to the upper genital tract, with endometritis as an intermediate stage in the pathogenesis of disease. The hallmark of the diagnosis is pelvic diagnosis combined with inflammation of the lower genital tract; women with PID often have a very subtle symptoms and signs.

Pelvic inflammatory disease is common. More than one million U.S. women get PID every year. As a result of PID, more than 100,000 women become infertile each year. In addition, a large proportion of the 100,000 ectopic (tubal) pregnancies that occur each year can be linked to PID. The rate of infection is highest among teenagers.

PID can lead to serious, long-term problems –

  • Infertility—One in ten women with PID becomes infertile. PID can cause scarring of the fallopian tubes. This scarring can block the tubes and prevent an egg from being fertilized.
  • Ectopic pregnancy—Scarring from PID also can prevent a fertilized egg from moving into the uterus. Instead, it can begin to grow in the fallopian tube. The tube may rupture (break) and cause life-threatening bleeding into the abdomen and pelvis. Emergency surgery may be needed if the ectopic pregnancy is not diagnosed early.
  • Chronic pelvic pain—PID may lead to long-lasting pelvic pain.

Causes

In most cases the PID is caused by an infection which starts in the vagina and then makes it way to the cervix, and can move onto the fallopian tubes and ovaries. Often more than one type of bacteria may be causing the infection.

  • Chlamydia and Gonorrhea – Chlamydia is the most common cause (50% to 65% of cases in the UK), followed by gonorrhea (14% of cases in the UK). Sometimes PID may be caused by a combined Chlamydia-gonorrhea infection.
  • Childbirth, abortion or miscarriage – bacteria can get into the vagina during/after childbirth, abortion or miscarriage; it then multiplies and spreads, causing PID. The infection can spread more easily because the cervix may not have fully closed.
  • IUD – the intrauterine device, also known as a coil can increase the risk of infection which may lead to PID.
  • Endometrial biopsy – this procedure, during which a sample of tissue is taken for analysis, has a risk of infection and subsequent PID.
  • Appendicitis – there is a slight risk of developing PID if a woman has appendicitis.
  • Women who are sexually active and less than 25 years of age, have several sexual partners, or do not use barrier contraceptives have a higher risk of developing PID.

Symptoms

Some women with PID have only mild symptoms or have no symptoms at all. Because the symptoms can be vague, many cases are not recognized by women or their gynecologists or other health care professionals. Listed are the most common signs and symptoms of PID:

  • Abnormal vaginal discharge
  • Pain in the lower abdomen (often a mild ache)
  • Pain in the upper right abdomen
  • Abnormal menstrual bleeding
  • Fever and chills
  • Painful urination
  • Nausea and vomiting
  • Painful sexual intercourse
  • Fatigue

Having one of these signs or symptoms does not mean that you have PID. It could be a sign of another serious problem, such as appendicitis or ectopic pregnancy. You should contact your gynecologist or other health care professional if you have any of these signs or symptoms.

Treatment

PID can be treated. However, treatment of PID cannot reverse the scarring caused by the infection. The longer the infection goes untreated, the greater the risk for long-term problems, such as infertility.

  • Antibiotics – treatment for PID depends on the cause, but usually involves administering antibiotics. If the patient does not respond to antibiotic treatment within three days she should go back to her doctor or hospital, who may recommend intravenous antibiotic therapy or a change of medication.

As PID is frequently caused by more than just one type of bacteria at any one time, doctors tend to prescribe two antibiotics, which are taken together. As soon as the doctor knows which bacterium or bacteria are causing the disease, antibiotic therapy may become more targeted. Examples of antibiotics for PID include ofloxacin, metronidazole, ceftriaxone and doxycycline.

A course of antibiotics usually lasts 14 days. Patients with very severe symptoms will be hospitalized and receive their medication intravenously.

  • Surgery – the fallopian tubes may have scarring, or there may be abscesses that need to be drained. Surgery may be needed, either laparoscopy (keyhole surgery) or salpingectomy (removal of one or both fallopian tubes). Doctors are reluctant to remove both fallopian tubes, because the woman will not be able to get pregnant naturally.
  • Sexual partner – the doctor may advise the woman to have her sexual partner checked and if necessary, treated for an STD (sexually transmitted disease). If the partner has an STD there is a serious risk of recurrence.

Alternative Treatment

A comprehensive treatment plan for PID may include a range of alternative therapies.

  • Nutritional Supplement –
    • Multivitamin supplement – Intake of antioxidant vitamins A, C, and E, the B complex vitamins and trace minerals such as magnesium, calcium, zinc and selenium.
    • Omega 3 fatty acids – Intake of fish oil help reduce inflammation.
    • Probiotic – Probiotic yogurt that contains live cultures (good bacteria) is a great remedy to fight this bacterial infection. The good bacteria in this yogurt will help fight the bad bacteria and restore good bacteria in your vagina. It also helps maintain a healthy vaginal pH balance.
    • Vitamin C This vitamin is essential for the proper functioning of the immune system. It also helps with the formation of collagen, which is very important if you are suffering from a vaginal infection or PID. Collagen is a protein that is found in an abundant supply in the body. It maintains the integrity of skin, ligaments, tendons and bone. If the collagen matrix (which is the main component of connective tissue) is intact, infection is less likely to spread, and your organs are less likely to become scarred by the infection. The bacteria can spread through the connective tissue so having extra vitamin C at this time will help to strengthen the connective tissue, make it more resistant, and decrease the time it takes for your body to repair damaged tissue.

o   Beta-carotene – Beta-carotene is a type of vitamin A that is known to help your body produce collagen, and it also helps to keep your cartilage strong. It is important that you have adequate levels in your body to help stop the spread of infection. Beta-carotene is also a powerful antioxidant and is found in high concentrations in the ovaries. However, if there isn’t enough in the body, levels in the ovaries will be inadequate, and the ovaries will be less likely to be able to fight off attacking infectious agents. Studies show that adequate levels of beta-carotene can help to prevent excess cell damage. Beta-carotene is also vital for immune function and for the normal growth of the type of tissue found in the vagina.

  • Garlic – Often called ‘nature’s antibiotic’, garlic is very important while you are trying to fight off an infection because it has strong antibacterial properties. So not only can it help to deal with the present infection, but it can help to prevent a recurrence by making the body an inhospitable place for invaders
  • Herbs – Herbs are one way to strengthen and tone the body’s systems.
    • Green Tea
    • Cat’s claw
    • Bromelain
    • Reishi Mushroom
    • Olive Leaf
  • Acupuncture – Acupuncture may help enhance immune function and reduce pain and inflammation, especially in women with chronic PID. Acupuncturists often target their protocols to draining what they call “Damp Heat” from the area. This is done using both acupuncture and Chinese herbal preparations.

 

 

Reference –

http://www.marilynglenville.com/womens-health-issues/vaginal-infections/

http://www.earthclinic.com/cures/pelvic_inflammatory_disease.html

http://www.webmd.com/women/tc/pelvic-inflammatory-disease-home-treatment

http://infertiltysolutionsng.info/blog/natural-treatment-for-pelvic-inflammatory-disease-pid/

http://emedicine.medscape.com/article/256448-treatment

http://www.mayoclinic.org/diseases-conditions/pelvic-inflammatory-disease/basics/treatment/con-20022341

http://www.mayoclinic.org/diseases-conditions/pelvic-inflammatory-disease/basics/treatment/con-20022341

http://www.nejm.org/doi/pdf/10.1056/NEJMra1411426

http://www.medicinenet.com/pelvic_inflammatory_disease/article.htm

http://www.medicinenet.com/pelvic_inflammatory_disease/article.htm

http://www.marilynglenville.com/womens-health-issues/vaginal-infections/

 

 

Posted in INFECTIOUS
February 8, 2017

PANDAS, is an abbreviation for Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections. The term is used to describe a subset of children who have Obsessive Compulsive Disorder (OCD) and/or tic disorders such as Tourette’s Syndrome, and in whom symptoms worsen following strep infections such as “Strep throat” and Scarlet Fever.

The symptoms are usually dramatic, happen “overnight and out of the blue,” and can include motor and/or vocal tics, obsessions, and/or compulsions. In addition to these symptoms, children may also become moody, irritable, experience anxiety attacks, or show concerns about separating from parents or loved ones.

PANDAS was first discovered in 1998 by Dr. Susan Swedo during a Pediatric Obsessive Compulsive Disorder study when it was found some children’s OCD behaviors began shortly after a strep infection. In any autoimmune disease, it is the consequence of a misguided immune response against self-antigens by autoantibodies that results in the damage of specific organs. In the case of PANDAS, the child’s brain is being attacked.

In every bacterial infection, the body produces antibodies against the invading bacteria, and the antibodies help eliminate the bacteria from the body. However in Rheumatic Fever, the antibodies mistakenly recognize and “attack” the heart valves, joints, and/or certain parts of the brain. This phenomenon is called “molecular mimicry”, which means that proteins on the cell wall of the strep. bacteria are similar in some way to the proteins of the heart valve, joints, or brain. Because the antibodies set off an immune reaction which damages those tissues, the child with Rheumatic Fever can get heart disease (especially mitral valve regurgitation), arthritis, and/or abnormal movements known as Sydenham’s Chorea or St. Vitus Dance. In PANDAS, it is believed that something very similar to Sydenham’s Chorea occurs. One part of the brain that is affected in PANDAS is the Basal Ganglia, which is believed to be responsible for movement and behavior. Thus, the antibodies interact with the brain to cause tics and/or OCD, instead of Sydenham Chorea.

Causes

The strep bacteria is a very ancient organism which survives in its human host by hiding from the immune system as long as possible. It does this by putting molecules on its cell wall that look nearly identical to molecules found on the child’s heart, joints, skin, and brain tissues. This is called “molecular mimicry” and allows the strep bacteria to evade detection for a time.

However, the molecules on the strep bacteria are eventually recognized as foreign to the body and the child’s immune system reacts to them by producing antibodies. Because of the molecular mimicry, the antibodies react not only with the strep molecules, but also with the human host molecules that were mimicked.

The cross-reactive antibodies then trigger an immune reaction that “attacks” the mimicked molecules in the child’s own tissues. Studies show that some cross-reactive “anti-brain” antibodies target the brain, causing OCD, tics, and the other neuropsychiatric symptoms of PANDAS.

A leaky gut, whereby undigested proteins, pathogens, and toxins can pass into the bloodstream provoking inflammation and immune reaction generally underlies autoimmunity. It also makes absorption of nutrients difficult which adds to immune dysfunction. Over 70% of the immune system is in the gut.

Who is at risk?

ANDAS is a rare condition. It is believed that approximately one in 2,000 children are affected, though the diagnosis may be overlooked due to some of the common symptoms associated with the disease. In fact, there are some researchers who recommend including PANDAS in a category of other disorders which include similar neuropsychiatric symptoms called CANS (childhood acute neuropsychiatric symptoms) or PANS (pediatric acute-onset neuropsychiatric syndrome).

PANDAS is considered a pediatric disorder and typically first appears in childhood from age 3 to puberty. Reactions to strep infections are rare after age 12, but the investigators recognize that PANDAS could occur (rarely) among adolescents. It is unlikely that someone would experience these post-strep neuropsychiatric symptoms for the first time as an adult, but it has not been fully studied.

It is possible that adolescents and adults may have immune-mediated OCD, but this is not known

Symptoms

Children with PANDAS seem to have dramatic ups and downs in their OCD and/or tic severity. Tics or OCD which are almost always present at a relatively consistent level do not represent an episodic course. Many kids with OCD or tics have good days and bad days, or even good weeks and bad weeks. However, patients with PANDAS have a very sudden onset or worsening of their symptoms, followed by a slow, gradual improvement. If they get another strep infection, their symptoms suddenly worsen again. The increased symptom severity usually persists for at least several weeks, but may last for several months or longer. The tics or OCD then seem to gradually fade away, and the children often enjoy a few weeks or several months without problems. When they have another strep throat infection, the tics or OCD may return just as suddenly and dramatically as they did previously. Symptom onset includes Primary ONSET of OCD and/or Severe Anxiety along with at least two other following symptoms –

  • Obsessive compulsive disorder
  • Tics (motor and verbal)
  • Sensory Processing Disorder
  • ADD/ADHD
  • Age regression
  • Choreiform movements
  • Hyperactivity
  • Mood fluctuations
  • Changes in handwriting
  • Personality changes
  • Oppositional Defiant Disorder
  • Deterioration in math skills
  • Separation anxiety
  • Depression
  • Rages
  • Urinary incontinence, urgency and increased frequency (daytime or nighttime)
  • Anorexia

Treatment

Treatment options for children who are diagnosed with PANDAS are emerging.  The most common initial intervention is a combination of cognitive behavioral therapy (CBT), SSRI medications, antibiotics (with a minimum trial of 4-5 weeks), and supplements (such as vitamin D, Omega 3, and probiotics).  While some children may exhibit an improvement in symptoms when using antibiotics or SSRI medications, it is also often recommended to consult with a psychologist that is experienced in this area.

Often, the treatment protocol for PANDAS includes exposure and ritual prevention (ERP), which is a specific type of CBT. Using ERP, the psychologist helps the child to understand their obsessions, compulsions, and movements, how to challenge these symptoms as well as related anxiety. It is also important that the child learn specific therapeutic and stress management skills to practice in between sessions.  ERP is also used to lessen the probability and severity of future exacerbations.

doctor may prescribe penicillin, amoxicillin (Amoxil), azithromycin (Zithromax), or another antibiotic. For severe and refractory symptoms, the use of other treatments aimed at controlling the immune response have been studied and found to be effective. These include the use of intravenous immunoglobulin, steroids, and plasmapheresis (plasma exchange therapy in which blood is withdrawn from an individual and the liquid portion is removed and replaced and the blood is transfused back into the individual).

Alternative Treatment

  • N-acetyl cysteine/NAC has been found to help with some OCD symptoms.
  • Natural anti-inflammatories, such as Curcumin, can be also useful.
  • Natural antibiotics/anti-virals such as Olive Leaf Extract/OLE and Grapefruit Seed Extract/GSE.
  • Omega-3 supplements can support healthy brain function.
  • Using probiotics is very important to ensure optimum gut flora environments are not depleted during antibiotic treatments and for good overall immunity. As a precaution, avoid any that contain the streptococcus thermophilus strain.

 

 

Reference –

http://patient.info/doctor/pandas-paediatric-autoimmune-neuropsychiatric-disorder-associated-with-streptococcal-infection

http://www.pandasnetwork.org/SWEDOMRIstudy2000281%5B1%5D.pdf

http://www.adhd.com.au/PANDAS.htm

http://latitudes.org/dr-william-walsh-autism-ocd-pandas-depression-methylation/

http://www.chinatourmap.com/panda/diet.html

 

 

Posted in INFECTIOUS
February 8, 2017

Mycoplasma pneumonia is a common respiratory pathogen that produces diseases of varied severity ranging from mild upper respiratory tract infection to severe atypical pneumonia. This type of pneumonia is also called atypical pneumonia because the symptoms are different from those of pneumonia due to other common bacteria.

Mycoplasma pneumoniae infection is spread when an infected person talks, coughs or sneezes small droplets containing infectious agents into the air. The droplets in the air may be breathed in by those nearby. Infection may be spread by contact with hands, tissues and other articles soiled by infected nose and throat discharges. Mycoplasma pneumoniae infection is also spread by direct contact with the infected person.

Causes

Mycoplasma pneumonia usually affects people younger than 40. People who live or work in crowded areas such as schools and homeless shelters have a high chance of getting this condition. But many people who get sick with it have no known risk factors.

Mycoplasma pneumoniae infection is spread when an infected person talks, coughs or sneezes small droplets containing infectious agents into the air. The droplets in the air may be breathed in by those nearby. Infection may be spread by contact with hands, tissues and other articles soiled by infected nose and throat discharges. Mycoplasma pneumoniae infection is also spread by direct contact with the infected person.

Risk Factors

Mycoplasma pneumoniae is a common cause of respiratory infections in school-age children and young adults. (Mycoplasma pneumoniae infection is rare in children younger than 5.) Cough, sore throat, fever, and fatigue are common symptoms. Many people will have only mild infection and will recover on their own.

  • Older adults
  • People who have diseases that compromise their immune system, such as HIV
  • People who have lung disease
  • People who have sickle cell disease
  • Children younger than age 5

People at highest risk include those who live or work in crowded settings, such as –

  • Schools
  • College dormitories
  • Military barracks
  • Nursing homes
  • Hospitals

People at risk for severe disease include people:

  • Recovering from a respiratory illness
  • With a weakened immune system
  • With asthma

Symptoms

The most common type of illness, especially in children, is tracheobronchitis, commonly known as chest cold. This chest cold often comes with a few types of upper respiratory tract symptoms –

  • Sore throat
  • Being tired (fatigue)
  • Fever
  • Slowly worsening cough that can last for weeks or months
  • Headache

Children younger than 5 years old often do not run a fever when they have M. pneumoniae infection. Instead they may have signs that appear more like a cold than pneumonia. They sometimes wheeze, vomit, and have diarrhea.

Less common symptoms include –

  • Ear pain
  • Eye pain or soreness
  • Muscle aches
  • joint stiffness
  • and
  • Neck lump
  • Rapid breathing
  • Skin lesions or rash

Complications

  • Central nervous system problems
  • Hematologic problems
  • Musculoskeletal problems
  • Skin problems
  • Gastrointestinal problems
  • Renal problems
  • Ophthalmologic problems
  • Cardiac problems

Treatment

Mycoplasma infection is usually treated with a macrolide antibiotic, usually erythromycin or roxithromycin. These reduce infectivity to others, and may improve respiratory symptoms as well as associated skin rash.

Clarithromycin, and azithromycin are more expensive, and may require approval from an Infectious Diseases Physician for their use in New Zealand. They require less frequent dosing than erythromycin or roxithromycin, and are less likely to result in gastrointestinal side effects.

No vaccine is available for Mycoplasma pneumoniae infection.

Macrolides, the first choice of antibiotics for children, include –

  • erythromycin
  • clarithromycin
  • roxithromycin
  • azithromycin

Antibiotics prescribed for adults include –

  • doxycycline
  • tetracycline
  • quinolones

Corticosteroids – Not all people respond to antibiotic treatment. Alternative treatments include the following corticosteroids –

  • prednisolone
  • methylprednisone

 

 

 

Posted in INFECTIOUS
February 8, 2017

Mononucleosis, also known as the “kissing disease,” or simply “mono,” is a group of symptoms that occur in some individuals who become infected with Epstein-Barr virus (EBV). It is a common infection and often causes minimal symptoms, especially when children have it. However, in adolescents and young adults, it often causes more intense symptoms and missed school. At least 25% of teenagers and young adults who get infected with EBV will develop infectious mononucleosis.

Mononucleosis is transmitted primarily by oral contact with exchange of saliva—hence its popular name, “the kissing disease.” The incubation period is thought to be about 30 to 40 days. The disease incapacitates individuals for varying periods of time; some affected people are physically fit for normal activities within two or three weeks, while others remain ill for as long as two months.

Causes

Mononucleosis is caused by the epstein-barr virus, a member of the herpes virus family. The disease develops if the virus is encountered for the first time at an age when the response of the body’s immune system is most vigorous (that is, during adolescence and early adult life). The peak incidence of the illness occurs around the ages of 15 and 17.

Mono is contagious, although less so than the common cold. EBV passes from person to person primarily through contact with saliva. Kissing and sharing food, drinks, or utensils commonly spread the virus. Although EBV is present in the respiratory tract * , it usually is not transmitted by coughing or sneezing. Some people will become sick and be able to spread the virus for weeks, especially those who are infected but do not feel sick and pass the virus to others without realizing it. The virus usually remains inactive after the first infection, but some people may spread it from time to time throughout their life.

Risk Factors

The following factors can raise your risk for developing mono –

  • Age- Mono is most common among people ages 15 to 24. After age 35, the rate is low.
  • Blood transfusion
  • Weakened immune system

Symptoms

Mono is most commonly characterized by the following symptoms –

  • Sore throat
  • Fatigue
  • Swollen glands (enlarged lymph nodes) in the neck and possibly elsewhere

Additional symptoms may also be present, including –

  • Fever
  • Headache
  • Nausea
  • Muscle aches
  • Rash
  • Enlarged spleen (the organ that lies under the left-side of the rib cage)

The time between when a person is exposed to mono and when symptoms appear is around 30 to 50 days. Fever and sore throat usually go away first, but fatigue and lymph node swelling may last for one to two months. Mono is most contagious during this first period, when the fever and sore throat are present.

Complications

Severe complications are uncommon. They may include anemia, problems with the central nervous system or liver, rupture of the spleen, or inflammation of the heart. People who have had mononucleosis are at incresed risk of developing multiple sclerosis (MS).

Treatment

There is no cure for mono, but your health care provider may prescribe the following medications to treat your symptom

  • Treating secondary infections – Occasionally, a streptococcal (strep) infection accompanies the sore throat of mononucleosis. Patients may also develop a sinus infection or an infection of the tonsils (tonsillitis).
  • Risk of rash with some medications – Amoxicillin and other penicillin derivatives aren’t recommended for people with mononucleosis. In fact, some people with mononucleosis who take one of these drugs may develop a rash. The rash, however, doesn’t necessarily mean that they’re allergic to the antibiotic. If needed, other antibiotics that are less likely to cause a rash are available to treat infections that may accompany mononucleosis.
  • Self Help
    • Rest
    • Eating healthy foods
    • Drinking lots of fluids

Alternative Treatment

Omega-3 fatty acids, such as fish oil, to help reduce inflammation and improve immunity.

Probiotic supplement for gastrointestinal and immune health.

Vitamin C – A water soluble vitamin, vitamin C is necessary for normal growth and development. Vitamin C is also an antioxidant and immune support. As such, vitamin C is an effective component of a mono treatment regimen for supporting the immune system and shortening the duration of the condition.

Green tea for antioxidant, anti-inflammatory, and immune effects.

Echinacea to strengthen the immune system.

Astragalus seem to kill viruses.

Cranberry appears to fight viruses, although no one knows whether it works against the EBV.

Acupuncture – Although no scientific studies have reviewed the use of acupuncture for mono, it may help reduce symptoms, improve immune function, and relieve congestion (blockage of qi, or energy flow) of the liver, spleen, and lymph.

Traditional Chinese Medicine – Studies show that people with EBV have fewer symptoms when given a combination of homeopathic remedies noted in the section on homeopathy and TCM remedies including Atractylodes alba, Glycyrrhiza recens, Rehmannia preparata, Bupleurum, Cortex magnolia, Phragmites, Belamcanda, Sophora, subprostrata, Siler, Angelica dahurica, Paeonia alba, Dendrobium, Polygonatum officinal, and Cnidium. Chinese herbs are prescribed on an individual basis.

 

Reference –

http://familydoctor.org/familydoctor/en/diseases-conditions/mononucleosis/treatment.html

http://www.medicinenet.com/infectious_mononucleosis/article.htm

http://www.mayoclinic.org/diseases-conditions/mononucleosis/diagnosis-treatment/treatment/txc-20165946

http://kidshealth.org/en/parents/mono.html

http://emedicine.medscape.com/article/222040-overview

http://www.pamf.org/teen/health/diseases/mono.html

http://umm.edu/health/medical/altmed/condition/mononucleosis

http://www.fpnotebook.com/id/virus/Mncls.htm

http://www.childrenshospital.org/conditions-and-treatments/conditions/i/infectious-mononucleosis/treatments

http://www.nature.com/cti/journal/v4/n2/full/cti20151a.html

http://www.encyclopedia.com/topic/infectious_mononucleosis.aspx

https://www.sciencedaily.com/terms/infectious_mononucleosis.htm

https://www.nlm.nih.gov/medlineplus/infectiousmononucleosis.html

http://www.humanillnesses.com/Infectious-Diseases-He-My/Mononucleosis-Infectious.html

 

Posted in INFECTIOUS
February 8, 2017

Molluscum contagiosum is a viral skin infection that causes either single or multiple raised, pearl-like bumps (papules) on the skin. It is a chronic infection, so lesions may persist from a few months to a few years. However, most cases resolve in six to nine months. It produces harmless, noncancerous growths in the skin’s top layers. The disease is spread by direct contact with the skin of an infected person or sharing towels with someone who has the disease. Outbreaks have occasionally been reported in child care centers.

Molluscum is a common skin problem with small, harmless raised spots. The spots can stay on the body for a few weeks, several months or more than a year. It is caused by the Molluscum Contagiosum Virus (MCV). This virus only lives in humans.

The lesions, known as Mollusca, are small, raised, and usually white, pink, or flesh-colored with a dimple or pit in the center. They often have a pearly appearance. They’re usually smooth and firm. In most people, the lesions range from about the size of a pinhead to as large as a pencil eraser (2 to 5 millimeters in diameter). They may become itchy, sore, red, and/or swollen.

Molluscum is contagious and can be spread from person to person or to different areas in the same person. It can also be spread by children sharing baths or pools through bath toys and towels. Usually it does not need any treatment. Good personal hygiene can help prevent it spreading.

Causes

Molluscum contagiosum is caused by a virus that is a member of the poxvirus family. You can get the infection in different ways.

This is a common infection in children and occurs when a child comes into direct contact with a lesion or an object that has the virus on it. The infection is most often seen on the face, neck, armpit, arms, and hands. But it may occur anywhere on the body, except the palms and soles.

The virus can spread through contact with contaminated objects, such as towels, clothing, or toys.

The virus also spreads by sexual contact. Early lesions on the genitals may be mistaken for herpes or warts. But unlike herpes, these lesions are painless.

Persons with a weakened immune system (due to conditions such as HIV/AIDS) may have a rapidly spreading case of molluscum contagiosum.

Risk Factors

Molluscum contagiosum is common enough that you should not be surprised if you see someone with it or if someone in your family becomes infected. Although not limited to children, it is most common in children 1 to 10 years of age.

People at increased risk for getting the disease include –

  • People with weakened immune systems (i.e., HIV-infected persons or persons being treated for cancer) are at higher risk for getting molluscum contagiosum. Their growths may look different, be larger, and be more difficult to treat.
  • Atopic dermatitis may also be a risk factor for getting molluscum contagiosum due to frequent breaks in the skin. People with this condition also may be more likely to spread molluscum contagiousm to other parts of their body for the same reason.
  • People who live in warm, humid climates where living conditions are crowded.

In addition, there is evidence that molluscum infections have been on the rise in the United States since 1966, but these infections are not routinely monitored because they are seldom serious and routinely disappear without treatment.

Symptoms

Bumps on the skin can be  the only sign that a person has molluscum contagiosum. These bumps often appear about 7 weeks after being exposed to the virus that causes molluscum. Sometimes, the bumps do not appear for many months.

When the bumps appear on the skin, they often –

  • Begin as small, firm, dome-shaped growths.
  • Have a surface that feels smooth, waxy, or pearly.
  • Are flesh-colored or pink.
  • Have a dimple in the center. The dimple may be filled with a thick, white substance that is cheesy or waxy.
  • Are painless, but some bumps itch.
  • Turn red as the person’s immune system fights the virus.
  • Appear on other areas of the body after a person scratches or picks the bumps. Scratching or picking can spread the virus.

In adults, the bumps often appear on the face, neck, armpits, arms, and hands. Other common places for bumps to appear are the genitals, abdomen, and inner thighs. Adults often get molluscum contagiosum through sexual contact.

If a person has a disease that weakens the immune system, such as AIDS, the bumps can grow very large. A person may have 100 or more bumps on the face alone.

Complications

Problems that can occur include any of the following –

  • Persistence, spread, or recurrence of lesions
  • Secondary bacterial skin infections

Treatment

Treatment for molluscum is usually recommended if lesions are in the genital area (on or near the penis, vulva, vagina, or anus). If lesions are found in this area it is a good idea to visit your healthcare provider as there is a possibility that you may have another disease spread by sexual contact.

Oral therapy – Gradual removal of lesions may be achieved by oral therapy. This technique is often desirable for pediatric patients because it is generally less painful and may be performed by parents at home in a less threatening environment.

Podophyllotoxin cream (0.5%) is reliable as a home therapy for men but is not recommended for pregnant women because of presumed toxicity to the fetus.

Therapy for immunocompromised persons – Most therapies are effective in immunocompetent patients; however, patients with HIV/AIDS or other immunosuppressing conditions often do not respond to traditional treatments. In addition, these treatments are largely ineffective in achieving long-term control in HIV patients.

Physical removal of lesions may include cryotherapy (freezing the lesion with liquid nitrogen), curettage (the piercing of the core and scraping of caseous or cheesy material), and laser therapy. These options are rapid and require a trained health care provider, may require local anesthesia, and can result in post-procedural pain, irritation, and scarring.

Laser therapy – Pulsed dye laser therapy is the treatment of choice when there are multiple lesions. Any surgical treatment requires to be repeated each time, new crops of lesions appear.

Cryotherapy – It involves killing infected cells by “freezing” them with a pressurized liquid spray, usually liquid nitrogen or nitrous oxide. The procedure is relatively painless and can be performed by any health professional. The infected cells may fall off immediately or fade over several days.

Alternative Treatment

Zell Oxygen is an incredible remedy to activate and strengthen the immune system and will speed a successful outcome over chronic (long term) and acute (short term) infections is most likely.

Collodial Silver  has been found to attack all known harmful virus and bacteria.

Olive Leaf Extract is rapidly being recognised as a natural alternative to antibiotics. Extremely beneficial for people with viral and fungal infections and a non-toxic way to strengthen the immune system. Scientific research has shown that the active ingredient in olive leaf extract, oleuropein, has powerful healing properties and can fight bacteria, viruses, fungi and parasites that cause infection and disease.

Vitamin Oils – Specific combinations of different vitamin oils to get rid of the papules caused by Molluscum Contagiosum.

Garlic – Molluscum is viral and caused by a pox virus, according to the Centers for Disease Control. Eating raw garlic might help the body’s immune system fight off the underlying virus, helping the eruptions to disappear more rapidly than ordinarily. Garlic has anti-viral and anti-fungal properties in its active ingredient allicin, which work to destroy viruses both internally and on the skin.

Turmeric, with its potent active ingredient curcumin, has properties that are reported to be anti-viral, anti-microbial and anti-inflammatory, making it an excellent natural remedy to boost the immune system, and one that might have potent effects on the mollusucm virus, hastening its demise in the body. Because turmeric has strong anti-inflammatory properties, it can not only be taken orally but the powered turmeric applied to the skin as a poltice

 

Reference –

https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/molluscum-contagiosum

http://www.hopkinsmedicine.org/healthlibrary/conditions/dermatology/molluscum_contagiosum_85,P00299/

http://www.mayoclinic.org/diseases-conditions/molluscum-contagiosum/basics/definition/con-20026391

http://www.cdc.gov/poxvirus/molluscum-contagiosum/risk.html

https://www.plannedparenthood.org/learn/stds-hiv-safer-sex/molluscum-contagiosum

http://www.dermnetnz.org/viral/molluscum-contagiosum.html

http://kidshealth.org/en/parents/molluscum-contagiosum.html

http://www.emedicinehealth.com/molluscum_contagiosum/article_em.htm

 

Posted in INFECTIOUS
February 8, 2017

Miliaria,  an inflammatory disorder of human skin, characterized by multiple small lesions at the site of sweat pores, brought about by the blockage of sweat ducts and the resulting escape of sweat into various levels of the skin. Most cases of miliaria occur in extremely hot weather; the lesions tend to disappear with cooler weather and the resultant decrease in sweating.

Miliaria affects all ages and races and doesn’t discriminate between men and women. It’s most common in children, especially neonates; their sweat ducts haven’t fully matured yet. The condition is often the reason for dermatologic consults in hospitalized patients who spend a lot of time in bed, under blankets.

Types

  • Miliaria crystallina is ductal obstruction in the uppermost epidermis, with retention of sweat subcorneally. It causes clear, droplike vesicles that rupture with light pressure.
  • Miliaria rubra (prickly heat) is ductal obstruction in the mid-epidermis with retention of sweat in the epidermis and dermis. It causes irritated, pruritic papules (prickling).
  • Miliaria pustulosa is similar to miliaria rubra but manifests as pustules rather than papules.
  • Miliaria profunda is ductal obstruction at the entrance of the duct into the dermal papillae at the dermo-epidermal junction, with retention of sweat in the dermis. It causes papules that are larger and more deeply seated than those of miliaria rubra. Papules are frequently painful.

Miliaria is most common in the first few weeks of life. It is especially common in hot, humid weather but almost any baby can get it. It is more common in babies who are bundled too warmly. Older children and adults can also get miliaria, in which case it is often called “prickly heat.”

Causes

Heat rash develops when some of your sweat ducts clog. Instead of evaporating, perspiration gets trapped beneath the skin, causing inflammation and rash. It’s not always clear why the sweat ducts become blocked, but certain factors seem to play a role, including –

  • Immature sweat ducts – A newborn’s sweat ducts aren’t fully developed. They can rupture more easily, trapping perspiration beneath the skin. Heat rash can develop in the first week of life, especially if the infant is being warmed in an incubator, is dressed too warmly or has a fever.
  • Tropical climates – Hot, humid weather can cause heat rash.
  • Physical activity – Intense exercise, hard work or any activity that causes people to sweat heavily can lead to heat rash.
  • Overheating – Overheating in general — dressing too warmly or sleeping under an electric blanket — can lead to heat rash.
  • Prolonged bed rest – Heat rash can also occur in people who are confined to bed for long periods, especially if they have a fever.

Risk Factors

  • Age – Newborns are most susceptible.
  • Tropical climates – People living in the tropics are far more likely to have heat rash than are people in temperate climates.
  • Physical activity – Anything that makes people sweat heavily, especially if people are not wearing clothing that allows the sweat to evaporate, can trigger heat rash

Symptoms

The following are the most common symptoms of prickly heat. However, each individual may experience symptoms differently. Symptoms may include –

  • Itching
  • Irritation (prickling)
  • Small blisters
  • Large, red areas on skin

The symptoms of prickly heat may resemble other skin conditions. Always consult your doctor for a diagnosis.

Complications

Heat rash usually heals without problems, but it can lead to infection with bacteria, causing inflamed and itchy pustules.

Treatment

Avoid further sweating – Even if this is achieved for only a few hours a day, as in an air-conditioned office or bedroom, considerable relief is experienced. For the very susceptible person a move away from tropical climates may be essential.

Do not irritate the skin – Avoidance of excessive clothing, friction from clothing, excesssive soap and contact of the skin with irritants will reduce the liability to miliaria. Shirts and blouses should be made of the new breathable synthetic fabrics where available, otherwise of cotton.

Cool water compresses and good ventilation will soothe inflamed areas.

Calamine lotion – Calamine is probably as effective as anything for relief of discomfort, but because of its drying effect an emollient may subsequently be required.

Topical steroids – For more marked cases, mild topical steroids often give reasonable relief of symptoms while natural resolution of the condition is awaited.

Antiseptics – Antiseptics and antistaphylococcal antibiotics can combat bacterial overgrowth.

 

Reference –

http://www.hopkinsmedicine.org/healthlibrary/conditions/dermatology/prickly_heat_85,P00307/

http://familydoctor.org/familydoctor/en/diseases-conditions/heat-rash/symptoms.html

http://www.msdmanuals.com/professional/dermatologic-disorders/sweating-disorders/miliaria

http://www.britannica.com/science/miliaria

http://www.drgreene.com/articles/miliaria/

http://www.whattoexpect.com/first-year/baby-care/baby-skin-care/heat-rash.aspx

 

 

Posted in INFECTIOUS
February 8, 2017

Measles, also known as Rubeola or morbilli, is a highly infectious illness caused by a virus – a viral infection caused by the rubeola virus. The disease is transmitted via airborne respiratory droplets, or by direct contact with nasal and throat secretions of infected individuals.

Measles is an endemic disease; meaning it is continually present in a community and many people develop resistance. If measles enters an area where the people have never been exposed the result can be devastating.

A measles outbreak in 1592 in the island of Cuba killed approximately two-thirds of the native population who had previously survived smallpox. A couple of years later half the indigenous population of Honduras died.

Before widespread immunisation against measles in industrialised countries, measles was a very common childhood disease that carried a high death rate. Nowadays in countries where measles is part of an immunisation programme, the risk of exposure and incidence of actual disease cases is low. However, because of a recent trend by some parents not to immunise their children, the number of cases of measles, and its complications, is once again increasing.

In developing countries, measles still occurs frequently and is associated with a high rate of complications and death. It remains a common disease even in some developed countries of Europe and Asia. Measles still causes more than a million childhood deaths each year.

Causes

Measles is caused by infection with the rubeola virus, a paramyxovirus of the genus Morbillivirus. The virus lives in the mucus of the nose and throat of an infected child or adult. The infected person is contagious for four days before the rash appears, and continues so for about four to five days afterwards.

People can become infected through –

  • Physical contact with an infected person.
  • Being nearby infected people if they cough or sneeze.
  • Touching a surface that has infected droplets of mucus (the virus remains active for two hours) and then putting your fingers into your mouth, rubbing your nose or eyes.

Risk Factors

Risk factors for measles include –

 

  • Being unvaccinated – If they haven’t received the vaccine for measles, they are much more likely to develop the disease.
  • Traveling internationally – If they travel to developing countries, where measles is more common, they are at higher risk of catching the disease.
  • Having a vitamin A deficiency – If they don’t have enough vitamin A in their diet, they more likely to contract measles and to have more-severe symptoms.

Symptoms

Measles is associated with the following signs and symptoms –

  • Moderate-to-high fever
  • Conjunctivitis (red, irritated eyes)
  • Cough
  • Sore throat, hoarseness
  • Runny nose
  • Red spots with bluish white centers (called Koplik spots) on the inside of the mouth
  • Red, blotchy, itchy rash, which begins on the face and then spreads
  • Enlarged lymph nodes
  • Rarely (1 in 1,000 cases), extreme drowsiness, seizure, or coma, suggesting involvement of the central nervous system
  • Gastrointestinal symptoms, including diarrhea, vomiting, and abdominal pain (these symptoms are less common)

Complications

Complications of measles may include –

  • Ear infection – One of the most common complications of measles is a bacterial ear infection.
  • Bronchitis, laryngitis or croup – Measles may lead to inflammation of the voice box (larynx) or inflammation of the inner walls that line the main air passageways of the lungs (bronchial tubes).
  • Pneumonia – Pneumonia is a common complication of measles. People with compromised immune systems can develop an especially dangerous variety of pneumonia that is sometimes fatal.
  • Encephalitis – About 1 in 1,000 people with measles develops encephalitis, an inflammation of the brain that may cause vomiting, convulsions, and, rarely, coma or even death. Encephalitis can closely follow measles, or it can occur months later.
  • Pregnancy problems – If women are pregnant, they need to take special care to avoid measles because the disease can cause pregnancy loss, preterm labor or low birth weight.
  • Low platelet count (thrombocytopenia) – Measles may lead to a decrease in platelets — the type of blood cells that are essential for blood clotting.

Treatment

  • Acetaminophen for high fevers – Children under 16 should not be given aspirin because of the danger of developing Reye syndrome.
  • Antibiotics for bacterial complications, such as pneumonia and ear infection
  • Immune gamma globulin followed by measles vaccination 5 to 6 months later

Alternative Treatment

A multivitamin daily, containing the antioxidant vitamins A, C, E, the B-vitamins and trace minerals, such as magnesium, calcium, zinc, and selenium.

Omega-3 fatty acids to reduce inflammation and improve immunity.

Probiotic supplement for maintenance of gastrointestinal and immune health. Some probiotic supplements need refrigeration.

Green tea for antioxidant, anti-inflammatory, and immune effects.

Cat’s claw for inflammation and antiviral activity.

Phyllanthus may slow blood clotting.

 

Reference –

http://patient.info/health/measles-leaflet

http://www.sfcdcp.org/measles.html

http://emedicine.medscape.com/article/966220-overview

http://www.vaccines.gov/diseases/measles/

http://www.webmd.com/children/vaccines/measles-faq

https://www.nlm.nih.gov/medlineplus/measles.html

http://www.medicalnewstoday.com/articles/37135.php

http://www.vaccineinformation.org/measles/

http://www.health.govt.nz/your-health/conditions-and-treatments/diseases-and-illnesses/measles

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Posted in INFECTIOUS
February 8, 2017

Marfan syndrome is a heritable disorder of the connective tissue that affects many organ systems, including the skeleton, lungs, eyes, heart and blood vessels. The condition affects both men and women of any race or ethnic group. It is estimated that at least 200,000 people in the United States have Marfan syndrome or a related connective tissue disorder.

Connective  tissues provide the framework that holds the body together and play an important role in growth and development. A person with Marfan syndrome has trouble making a protein called fibrillin. The body needs fibrillin to make connective tissue strong. Because connective tissue is found throughout the body, patients with Marfan syndrome have problems with a number of systems including bones, joints, eyes, heart, blood vessels, nervous system, skin, and lungs. The effects of Marfan syndrome varies between individuals, some people only being mildly affected.

Marfan syndrome is a birth defect. Birth defects are health conditions that are present at birth. Birth defects change the shape or function of one or more parts of the body. They can cause problems in overall health, how the body develops, or in how the body works. In about 1 in 4 cases, the mutation that causes Marfan syndrome is not inherited. Thus, the affected person is the first in his or her family to have the condition.

Marfan syndrome has no cure, but treatments can help delay or prevent complications. Treatments include medicines, surgery, and other therapies. Limiting certain activities, or changing how patients do them, may help reduce the risks to the aorta, eyes, and joints. The type of treatment patients receive depends on how the condition is affecting the body.

Causes

Marfan syndrome is caused by a defect in the gene that encodes the structure of fibrillin and the elastic fibers, a major component of connective tissue. This gene is called fibrillin-1 or FBN1.

In most cases, Marfan syndrome is inherited. The pattern is called “autosomal dominant,” meaning it occurs equally in men and women and can be inherited from just one parent with Marfan syndrome. People who have Marfan syndrome have a 50 percent chance of passing along the disorder to each of their children.

In 25 percent of cases, a new gene defect occurs due to an unknown cause. Marfan syndrome is also referred to as a “variable expression” genetic disorder, because not everyone with Marfan syndrome has the same symptoms to the same degree.

The gene defect also causes the long bones of the body to grow too much. People with this syndrome have tall height and long arms and legs. How this overgrowth happens is not well understood.

Other areas of the body that are affected include –

  • Lung tissue (there may be a pneumothorax, in which air can escape from the lung into the chest cavity and collapse the lung)
  • The aorta, the main blood vessel that takes blood from the heart to the body may stretch or become weak (called aortic dilation or aortic aneurysm)
  • The eyes, causing cataracts and other problems (such as a dislocation of the lenses)
  • The skin
  • Tissue covering the spinal cord

Marfan syndrome is present at birth. However, it may not be diagnosed until adolescence or young adulthood.

Risk Factors

Marfan syndrome affects men and women equally and occurs among all races and ethnic groups. Because it’s a genetic condition, the greatest risk factor for Marfan syndrome is having a parent with the disorder.

Symptoms

The signs and symptoms of Marfan syndrome develop over time. Only about 40% to 60% of patients with Marfan syndrome have symptoms, usually mitral valve prolapse or problems with the aorta.

Other signs of Marfan syndrome may include –

  • A tall and thin body frame, long and slender fingers, and long arms and legs.
  • A curved spine (called scoliosis).
  • Chest-wall deformities, such as a breast bone (sternum) that is caved in (indented) or sticking out (protruding). If the breast bone is indented, it may also be very narrow.
  • Eye or vision problems, such as nearsightedness or a detached retina.
  • Disproportionate growth, meaning people with Marfan syndrome are usually very tall.
  • Flat feet.
  • Loose joints (called joint laxity) or being double jointed.
  • Shortened muscles, tendons, and ligaments (called contracture).
  • About 90 percent of people with Marfan syndrome develop changes in their heart and blood vessels.
  • The heart’s valves, especially the mitral valve, can be affected by Marfan syndrome. The valve leaflets become floppy and do not close tightly, allowing blood to leak backwards across the valve (mitral valve prolapse, also called MVP). When MVP progresses, the valve leaks and the condition is called mitral valve regurgitation.
  • Decreased elasticity of the skin cause stretch marks to occur even without changes in weight.

Complications

Complications may include –

  • Aortic regurgitation
  • Aortic rupture
  • Bacterial endocarditis
  • Dissecting aortic aneurysm
  • Enlargement of the base of the aorta
  • Heart failure
  • Mitral valve prolapse
  • Scoliosis
  • Vision problems

Treatment

Medications are not used to treat Marfan syndrome, however they may be used to prevent or control complications. Medications may include –

  • A beta-blocker improves the heart’s ability to relax, decreases the forcefulness of the heartbeat and the pressure within the arteries, thereby preventing or slowing the enlargement of the aorta. Beta-blocker therapy should begin at an early age.
  • In people who are unable to take beta-blockers due to asthma or side-effects, a calcium channel blocker, such as verapamil, is recommended.
  • An angiotensin receptor blocker (ARB) is a type of medication that acts on a chemical pathway in the body. These agents are often used in treatment of high blood pressure as well as heart failure.

Surgery – Surgery for Marfan syndrome is aimed at preventing aortic dissection or rupture and treating valve problems. When the aorta diameter is more than 4.7 cm (centimeters) to 5.0 cm (depending on your height), or if the aorta is enlarging at a rapid pace, surgery is recommended. The cardiologist may also calculate the aortic root diameter to height ratio, since this may also influence whether the patient should have surgery.

Bone and Joint Treatments – If people have scoliosis (a curved spine), the doctor may suggest a brace or other device to prevent the condition from getting worse. Severe cases of scoliosis may require surgery.

Some people who have Marfan syndrome need surgery to repair a chest that sinks in or sticks out. This surgery is done to prevent the chest from pressing on the lungs and heart.

Eye Treatments – Marfan syndrome can lead to many eye problems, such as a dislocated lens, nearsightedness, early glaucoma (high pressure in the fluid in the eyes), and cataracts (clouding of an eye’s lens).

Glasses or contact lenses can help with some of these problems. Sometimes surgery is needed.

Nervous System Treatments – Marfan syndrome can lead to dural ectasia. In this condition, a substance called the dura (which covers the fluid around the brain and spinal cord) stretches and grows weak. This can cause the bones of the spine to wear away. Dural ectasia usually is treated with pain medicines.

Lung Treatments – Marfan syndrome may cause pneumothorax, or collapsed lung. In this condition, air or gas builds up in the space between the lungs and the chest wall.

Alternative Treatment

Protein or Amino acids are essential for many important roles in cellular and cardiovascular support i.e. Connective tissue and muscle development and mental/mood support.

Trace Minerals are invaluable for all those with connective tissue needs for repair of the ligaments to strength in the musculature and all connective tissue.

Magnesium is a macro mineral the is in great deficiency across the population that I see.   Epsom salt baths are great for this.  Magnesium allows for muscle relaxation and arterial dilation.

Vitamin C and bioflavinoids – Huge for connective tissue integrity by strengthening the all connective tissue and fighting off any free radical damage.

 

Reference –

http://my.clevelandclinic.org/services/heart/disorders/aortic-aneurysm/marfan

http://www.marfanvic.org.au/

http://www.msdmanuals.com/home/children’s-health-issues/hereditary-connective-tissue-disorders/marfan-syndrome

http://rarediseases.org/rare-diseases/marfan-syndrome/

http://www.hopkinsmedicine.org/heart_vascular_institute/clinical_services/centers_excellence/marfan_center.html

https://www.genome.gov/19519224

http://patient.info/doctor/marfans-syndrome-pro

http://www.ygyh.org/marfan/whatisit.htm

http://umm.edu/health/medical/ency/articles/marfan-syndrome

https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/marfan-syndrome

https://www.genome.gov/19519224

https://www.nhlbi.nih.gov/health/health-topics/topics/mar/causes

 

 

 

Posted in INFECTIOUS
February 8, 2017

Marburg virus is considered to be a re-emerging pathogen that poses a significant threat to human health. This naturally occurring virus can cause a fulminating hemorrhagic disease with a severe shock syndrome and high mortality in both humans and nonhuman primates – also known as Marburg hemorrhagic fever.

Marburg virus belongs to the family Filoviridae, which contains three genera – Ebolavirus, Marburgvirus and Cuevavirus. The genus Marburgvirus contains only one species: Marburg marburgvirus, more commonly termed Marburg virus. Its genome contains linear, non-segmented, single-stranded RNA molecule that is of a negative polarity.

The disease was first recognised in 1967, when outbreaks of haemorrhagic fever occurred simultaneously in laboratories in Marburg and Frankfurt in Germany, and Belgrade in Yugoslavia. A total of 31 people became ill, including 25 laboratory workers, and medical personnel and a family member who had cared for them. The laboratory workers all had contact with the blood, organs or cell-cultures from a batch of imported African green monkeys from north-western Uganda.

It is generally accepted that Marburg virus is a zoonotic (animal borne) virus. Fruit bats (Rousettus aegyptii) are considered the natural host of the virus. Monkeys are susceptible to Marburg virus infection but are not considered the reservoir hosts as they die rapidly once infected.

The Marburg virus is transmitted by direct contact with the blood, body fluids and tissues of infected persons. Transmission of the Marburg virus also occurred by handling ill or dead infected wild animals (monkeys, fruit bats). The predominant treatment is general supportive therapy.

Causes

Marbug, like Ebola, is not an airborne virus. The disease is spread through direct contact with the blood, tissues or bodily fluids of an infected person or, as has happened in many cases before, an infected primate or fruit bat.

Transmission from animals to humans

Experts suspect that Marburg virus are transmitted to humans through an infected animal’s bodily fluids. Examples include –

  • Blood – Butchering or eating infected animals can spread the viruses. Scientists who have operated on infected animals as part of their research have also contracted the virus.
  • Waste products – Tourists in certain African caves and some underground mine workers have been infected with the Marburg virus, possibly through contact with the feces or urine of infected bats.

Transmission from person to person

  • Infected people typically don’t become contagious until they develop symptoms. Family members are often infected as they care for sick relatives or prepare the dead for burial.
  • Medical personnel can be infected if they don’t use protective gear, such as surgical masks and gloves.

Risk Factors

For most people, the risk of getting Ebola or Marburg viruses (hemorrhagic fevers) is low. The risk increases if they –

  • Travel to Africa – People are at increased risk if they visit or work in areas where Marburg virus outbreaks have occurred.
  • Conduct animal research – People are more likely to contract the Marburg virus if they conduct animal research with monkeys imported from Africa or the Philippines.
  • Provide medical or personal care – Family members are often infected as they care for sick relatives. Medical personnel also can be infected if they don’t use protective gear, such as surgical masks and gloves.
  • Prepare people for burial – The bodies of people who have died of Marburg hemorrhagic fever are still contagious. Helping prepare these bodies for burial can increase your risk of developing the disease.

Symptoms

Marburg hemorrhagic fever is characterized by an abrupt onset presenting with fever, chills and myalgia. Two features of the disease are critical in its pathogenesis: endothelial damage orchestrated by both the virus and the up-regulation of toxic cytokines (with extensive vascular leakage as a consequence), and disseminated intravascular coagulation which leads to serious thrombocytopenia.

As a result, severe hemorrhage can ensue at several body sites within approximately 5 to 7 days after the onset of symptoms. Bleeding from the nose, gums, and eyes is commonly observed, whereas considerable gastrointestinal hemorrhage will often manifest as frank blood in the stool or vomit. Dehydration is a frequent consequence.

Symptoms include the following –

  • Maculopapular rashes that develop in the head, neck and stomach
  • High fever
  • Severe headache
  • Chills
  • Nausea
  • Vomiting
  • Abdomen pain
  • Cramping
  • Muscle pain
  • Sore throat
  • Chest pain
  • Fatigue
  • Watery diarrhea
  • Joint pain
  • Excessive weight loss
  • Delirium
  • Jaundice

The case-fatality ratio for this disease ranges from 23 to 90%. Survivors of Marburg hemorrhagic fever experience a prolonged convalescence characterized by myalgia, muscle weakness, arthralgia, myelitis, hepatitis, ocular disease, hearing loss, and in some instances even psychosis.

Complications

As the illness progresses, it can cause –

  • Multiple organ failure
  • Severe bleeding
  • Jaundice
  • Delirium
  • Seizures
  • Coma
  • Shock

Treatment

There is no specific treatment for Marburg hemorrhagic fever. Supportive hospital therapy should be utilized, which includes balancing the patient’s fluids and electrolytes, maintaining oxygen status and blood pressure, replacing lost blood and clotting factors, and treatment for any complicating infections.

Alternative Treatment

Vitamin C is essential for a strong immune system. Consuming the richest sources of this vital nutrient is important in preventing and during a cold.

Vitamin D – Vitamin D is vital for a strong immune system.

Zinc has been shown to speed up the recovery from colds and coughs.

Probiotic with active live cultures provides beneficial bacteria that have many important functions in the body including the manufacture of nutrients and aiding with digestion. They also help to improve the immune system.

Turmeric has powerful anti-microbial properties and can help to prevent colds and influenza when a half teaspoon is included in the daily diet.

Phyllanthus amarus herb is very effective in naturally treating colds and fevers.

 

Reference –

http://www.webmd.com/a-to-z-guides/marburg-hemorrhagic-fever

http://www.cdc.gov/vhf/marburg/

http://www.mayoclinic.org/diseases-conditions/ebola-virus/basics/definition/con-20031241

http://www.news-medical.net/health/Marburg-Virus.aspx

https://www.gov.uk/guidance/marburg-virus-disease-origins-reservoirs-transmission-and-guidelines

http://www.medicinenet.com/marburg_virus_history_symptoms_and_treatment/views.htm

http://www.phac-aspc.gc.ca/lab-bio/res/psds-ftss/marburg-eng.php

http://news.nationalgeographic.com/news/2014/08/140820-marburg-ebola-virus-treatment-monkey-africa/

http://www.pbs.org/frontlineworld/stories/uganda901/marburg.html

http://www.slate.com/articles/news_and_politics/explainer/2005/03/marburg_vs_ebola.html

 

Posted in INFECTIOUS