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VIRAL CONJUNCTIVITIS

Wednesday, December 22, 2010 | 8:59 am
Conjunctivitis due to viral infection is the leading cause of a red eye.
Patients typically present with an acutely red eye, watery discharge, and conjunctival and eyelid swelling. The disorder usually affects one eye first and the other several days later. A tender preauricular lymph node supports the diagnosis but is not present in the majority of cases. Viral conjunctivitis may develop during or after an upper respiratory tract infection and is usually self-limited.
Adenovirus is the most common cause of viral conjunctivitis and is often involved in community epidemics in schools or in the workplace. There are three common presentations of adenoviral conjunctivitis:
- Follicular conjunctivitis – This is the most common type of ocular adenoviral infection (typically due to serotypes 1, 2, 4, 5, and 6), and it affects children more frequently than adults. It is characterized by the presence of follicles – tiny, round, gray-white patches present on the palpebral conjunctiva. In severe cases, follicles may enlarge into papules and resemble cobblestones. The infection is self-limiting and generally resolves within 2 weeks.
- Pharyngoconjunctival fever – This adenoviral conjunctivitis (usually caused by serotypes 3 and 7) is characterized by the abrupt onset of high fever, pharyngitis, and bilateral follicular conjunctivitis. Small petechial hemorrhages can occur on the bulbar conjunctiva. The disease runs a course of 10 to 14 days.
- Epidemic keratoconjunctivitis – A particularly fulminant adenoviral infection (commonly associated with serotype 8), epidemic keratoconjunctivitis involves both the conjunctival and corneal epithelia. It is characterized by prominent conjunctival injection, a severe follicular response, and chemosis. Corneal infiltrates then occur, producing a foreign body sensation and photophobia that can prevent spontaneous opening of the eyes. Affected patients often drop several lines of visual acuity on a Snellen chart. The disease is usually self-limited but may take months to completely resolve.
Herpesviruses, particularly herpes simplex virus, may also cause conjunctivitis, although they typically involve the cornea. Herpes simplex virus can produce vesicular lid lesions, preauricular lymphadenopathy, and transient keratitis. Fluorescein staining of the cornea may reveal the dendritic pattern that is pathognomonic for herpetic keratitis.
*31/348/5*

VIRAL CONJUNCTIVITISConjunctivitis due to viral infection is the leading cause of a red eye. Patients typically present with an acutely red eye, watery discharge, and conjunctival and eyelid swelling. The disorder usually affects one eye first and the other several days later. A tender preauricular lymph node supports the diagnosis but is not present in the majority of cases. Viral conjunctivitis may develop during or after an upper respiratory tract infection and is usually self-limited.Adenovirus is the most common cause of viral conjunctivitis and is often involved in community epidemics in schools or in the workplace. There are three common presentations of adenoviral conjunctivitis:- Follicular conjunctivitis – This is the most common type of ocular adenoviral infection (typically due to serotypes 1, 2, 4, 5, and 6), and it affects children more frequently than adults. It is characterized by the presence of follicles – tiny, round, gray-white patches present on the palpebral conjunctiva. In severe cases, follicles may enlarge into papules and resemble cobblestones. The infection is self-limiting and generally resolves within 2 weeks.- Pharyngoconjunctival fever – This adenoviral conjunctivitis (usually caused by serotypes 3 and 7) is characterized by the abrupt onset of high fever, pharyngitis, and bilateral follicular conjunctivitis. Small petechial hemorrhages can occur on the bulbar conjunctiva. The disease runs a course of 10 to 14 days.- Epidemic keratoconjunctivitis – A particularly fulminant adenoviral infection (commonly associated with serotype 8), epidemic keratoconjunctivitis involves both the conjunctival and corneal epithelia. It is characterized by prominent conjunctival injection, a severe follicular response, and chemosis. Corneal infiltrates then occur, producing a foreign body sensation and photophobia that can prevent spontaneous opening of the eyes. Affected patients often drop several lines of visual acuity on a Snellen chart. The disease is usually self-limited but may take months to completely resolve.Herpesviruses, particularly herpes simplex virus, may also cause conjunctivitis, although they typically involve the cornea. Herpes simplex virus can produce vesicular lid lesions, preauricular lymphadenopathy, and transient keratitis. Fluorescein staining of the cornea may reveal the dendritic pattern that is pathognomonic for herpetic keratitis.*31/348/5*

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(posted in Anti-Infectives)

WHAT CAUSES BDD? CLUES TO AN UNSOLVED PUZZLE: PATIENTS’ PERSPECTIVES

Thursday, December 16, 2010 | 8:52 am
“I have no idea why I worry so much about how I look. I wish I
knew.”
Anne
Patients’ Perspectives
“This problem is chemical,” Bridget said. “I can’t think of any reason for these gut-wrenching worries about how I look. It must be from a chemical imbalance in my brain.” Alison’s explanation was quite different. “My mother is very pretty, and so is my sister,” she said. “I constantly tried to look like my older sister. She’s very feminine, and I idealized her. I wanted her nose, her long hair. I never accepted who I was. I was the ugly duckling, the odd-looking one. I was the runt of the litter.”
“I started worrying too much about my skin at a time when I was really stressed,” Caroline told me. “It began after I had to take a job working in a place I really didn’t want to work. And I started worrying that my rear end was too big after a guy in my class commented on my big ass. My father had also started drinking at the time. But I think these things were mostly triggers. I think my worries have deeper roots, like how I was always put down when I was growing up.”
“My father has bad skin,” Jamie said. “I look more like my father than like my mother. I worried my skin might end up like his.”
“Maybe I learned looks were important,” Brad told me. “My family stressed the importance of looks. We always had to look our best and be well-manicured no matter what…. Everyone paid lots of attention to my brother—he was the champ of the family and my father’s pet. I was always last on my parents’ list. … I was always very sensitive. I was always sensitive to criticism and rejection. I’m a perfectionist. I’ve always been hard on myself—since day one. I have high standards. My parents expected a lot from me. I was always the black sheep of the family.”
People with BDD have myriad and varied explanations for their symptoms. Some believe the cause is biological—perhaps a chemical imbalance in the brain. Others give a psychological explanation, citing their upbringing, identification with a particular person, or personality traits such as perfectionism or sensitivity to criticism or rejection. Others blame society’s emphasis on attractiveness. Some people attribute their symptoms to a comment or to stress in their lives at the time their concern began. Others have no explanation for their symptoms, but they search for one, trying to give their experience meaning. The explanations are varied and bear the stamp of each person’s unique autobiography.
This  topic—what causes BDD—is the most complex question in this book. At this time, BDD’s cause remains largely unexplored, and there are no definitive answers. This is the outermost edge of the BDD frontier. But even though we’re at the beginning of our search, our understanding of what causes BDD is steadily growing.
*165\204\8*

WHAT CAUSES BDD? CLUES TO AN UNSOLVED PUZZLE: PATIENTS’ PERSPECTIVES”I have no idea why I worry so much about how I look. I wish Iknew.”AnnePatients’ Perspectives”This problem is chemical,” Bridget said. “I can’t think of any reason for these gut-wrenching worries about how I look. It must be from a chemical imbalance in my brain.” Alison’s explanation was quite different. “My mother is very pretty, and so is my sister,” she said. “I constantly tried to look like my older sister. She’s very feminine, and I idealized her. I wanted her nose, her long hair. I never accepted who I was. I was the ugly duckling, the odd-looking one. I was the runt of the litter.”"I started worrying too much about my skin at a time when I was really stressed,” Caroline told me. “It began after I had to take a job working in a place I really didn’t want to work. And I started worrying that my rear end was too big after a guy in my class commented on my big ass. My father had also started drinking at the time. But I think these things were mostly triggers. I think my worries have deeper roots, like how I was always put down when I was growing up.”"My father has bad skin,” Jamie said. “I look more like my father than like my mother. I worried my skin might end up like his.”"Maybe I learned looks were important,” Brad told me. “My family stressed the importance of looks. We always had to look our best and be well-manicured no matter what…. Everyone paid lots of attention to my brother—he was the champ of the family and my father’s pet. I was always last on my parents’ list. … I was always very sensitive. I was always sensitive to criticism and rejection. I’m a perfectionist. I’ve always been hard on myself—since day one. I have high standards. My parents expected a lot from me. I was always the black sheep of the family.”People with BDD have myriad and varied explanations for their symptoms. Some believe the cause is biological—perhaps a chemical imbalance in the brain. Others give a psychological explanation, citing their upbringing, identification with a particular person, or personality traits such as perfectionism or sensitivity to criticism or rejection. Others blame society’s emphasis on attractiveness. Some people attribute their symptoms to a comment or to stress in their lives at the time their concern began. Others have no explanation for their symptoms, but they search for one, trying to give their experience meaning. The explanations are varied and bear the stamp of each person’s unique autobiography.This  topic—what causes BDD—is the most complex question in this book. At this time, BDD’s cause remains largely unexplored, and there are no definitive answers. This is the outermost edge of the BDD frontier. But even though we’re at the beginning of our search, our understanding of what causes BDD is steadily growing.*165\204\8*

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(posted in Anti Depressants-Sleeping Aid)

ARE YOU ASTHMATIC OR TOXIC?

Friday, December 10, 2010 | 8:36 am
Virtually any system can be affected [by xenobiotics]. Hypersensitivity to chemicals has been characterised as a backward disease. Instead of a systematic sequence of events resulting in a predictable set of signs and symptoms, it is a systematic sequence of events that results in an apparently random set of symptoms that can differ greatly from victim to victim with time. It is, therefore, not identifiable according to the rules of nosonomy.
Tabor 1986
There are five basic principles in environmental medicine, according to Dr Sherry Rogers, the world authority on the subject quoted earlier.
Total body load explains why reactions vary from day to day, are never the same and can vary from person to person.
Adaptation or masking can occur whereby the body gets ‘used to’ a toxin and adjusts itself for the time being. Meanwhile accumulation proceeds, the body is stressed and somewhere along the line an apparently sudden deterioration occurs.
Biochemical individuality and individual susceptibility mean that no two people will get exactly the same symptoms from the same exposure. Likewise, people with similar symptoms can have different causes.
Bipolarity: stimulation phase followed by a down. The stimulation can be misinterpreted as good and the individual may become addicted to the stimuli. He or she learns to repeat exposure or ingestion in order to avoid the ‘down’ phase, very much like an alcoholic.
The spreading phenomenon, where the pathways used to dispose of a toxin become more overloaded, damaged or depleted, so one becomes more and more sensitive to new factors and to lower doses of the same toxins. The ability to tolerate something decreases.
*23\145\2*

ARE YOU ASTHMATIC OR TOXIC?Virtually any system can be affected [by xenobiotics]. Hypersensitivity to chemicals has been characterised as a backward disease. Instead of a systematic sequence of events resulting in a predictable set of signs and symptoms, it is a systematic sequence of events that results in an apparently random set of symptoms that can differ greatly from victim to victim with time. It is, therefore, not identifiable according to the rules of nosonomy.Tabor 1986There are five basic principles in environmental medicine, according to Dr Sherry Rogers, the world authority on the subject quoted earlier.Total body load explains why reactions vary from day to day, are never the same and can vary from person to person.Adaptation or masking can occur whereby the body gets ‘used to’ a toxin and adjusts itself for the time being. Meanwhile accumulation proceeds, the body is stressed and somewhere along the line an apparently sudden deterioration occurs.Biochemical individuality and individual susceptibility mean that no two people will get exactly the same symptoms from the same exposure. Likewise, people with similar symptoms can have different causes.Bipolarity: stimulation phase followed by a down. The stimulation can be misinterpreted as good and the individual may become addicted to the stimuli. He or she learns to repeat exposure or ingestion in order to avoid the ‘down’ phase, very much like an alcoholic. The spreading phenomenon, where the pathways used to dispose of a toxin become more overloaded, damaged or depleted, so one becomes more and more sensitive to new factors and to lower doses of the same toxins. The ability to tolerate something decreases.*23\145\2*

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(posted in Asthma)

COUNSELLING – 2

Friday, October 8, 2010 | 4:12 am

Follow up. Patients treated for STDs should be informed of the need for follow up for test-of-cure. In conditions like herpes, HIV infection and human papilloma virus where there is no cure, follow-up for counselling, clinical and laboratory assessment and ongoing management are important.

Future prevention. Medical practitioners have an educative role in STD prevention and the counselling of STD patients offers both an opportunity and a challenge. Information about the method of spread of STDs and advice about reducing the risk of infection should be given. While the prophylactic use of condoms should be freely advocated where sexual activity exposes the individual to the risk of STD, the failure rate of condoms should be discussed.

Patients whose life style places them at risk of hepatitis В (e.g. prostitutes and homosexual men with multiple partners) should be tested for evidence of previous hepatitis В infection. Those who have no markers of hepatitis В should be encouraged to be immunised.
*27/56/1*
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(posted in Men's Health-Erectile Dysfunction | tagged , )

COUNSELLING

Friday, October 8, 2010 | 4:10 am

The following areas should be specifically covered in counselling: (i)  Diagnosis. The patient should be told the diagnosis, natural history of the disease, sequelae and the effectiveness of therapy.

(if) Treatment. The patient should be told the dose, frequency and duration of medication and the importance of compliance with the full course. Side effects of therapy and what the patient should do if they occur should be clearly explained.

(iii)       Sexual activity. Patients undergoing treatment should refrain from
sexual intercourse until treatment is complete. Patients with infectious
STD must be advised how to modify their sexual behaviour.

(iv)       Contact tracing. The importance of tracing and investigating the
sexual contacts of the patient must be stressed. Patients generally
respond well when it is explained that sexual partners may be
unaware of the infection and that untreated STDs can have serious
complications.

Information about contacts is sought in order to identify the source contact and to identify people to whom the infection may have spread. Patients are often incorrect in attributing the source of infection.

Contact tracing requires some expertise and public health agencies in the States and Territories may assist. It should be done formally with a list of the names and addresses of contacts and full records of communications with them together with outcomes of investigation, treatment and counselling. The patient’s private medical attendant may undertake the tracing and management of contacts. Patients can be their own contact tracers. Generally, the tracing of contacts of a patient with HIV infection should not be undertaken by the patient. Contact tracing can be a difficult and time consuming task and patients and practitioners may elect to have it done by officers of the health authority.
*26/56/1*
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(posted in Men's Health-Erectile Dysfunction | tagged , )

PLASTIC SURGERY FOR SKIN: THE UV GREMLINS INSIDE

Wednesday, June 16, 2010 | 8:51 am
Dermatologists see excessive tanning as Public Enemy Number 1 because it mars the skin with premature wrinkles, blotches,   bloated   blood   vessels,   and freckles. Worse, it can lead to cancer. Intense sunlight containing ultraviolet light penetrates deep inside your skin cells.
Thanks to a doctor’s quick action, Jane Kimbrough, 48, of Dobbs Ferry, New York, sailed past melanoma, or “black cancer.” In 1983, her doctor found a black dot on her big toe. Because it was promptly removed, she has less than a 1 percent chance of dying of melanoma in the next 10 years. Left to grow, that cancer kills 50 percent of its victims within 5 years.
“I had a friend who died of melanoma,” Ms. Kimbrough says. “I consider myself very fortunate.” The fair-skinned actress once worked at tanning but now shuns sun and regularly checks her body. Her physician, Dr. Darrell S. Rigel, a dermatologist at New York University Medical Center, estimates that 22,000 Americans developed melanoma last year, and 5,500 died of it.
“The biggest advance is the development of sunscreens,” says Dr. Rigel. “A number 15 sunscreen lets in only 1/15th of the rays. If people use such creams, the cancer rate will fall.” And, he adds, that includes basal cell cancer (the one that attacked President Reagan’s nose) and squamous cell cancer.
*147/266/5*

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(posted in General health | tagged )

SODIUM-RESTRICTED DIETS FOR PEOPLE WITH HEART DISEASES: PREPARATION OF FOOD

Wednesday, June 16, 2010 | 8:51 am
The booklets prepared by the American Heart Association contain menu suggestions and helpful hints for the preparation of food as well as guides for eating away from home.
Patients who have always used much salt at the table are likely to complain bitterly about the flat taste of the food. Others, who prefer foods only lightly salted, find the diet to be more tolerable. In time most patients find that they can adjust to the restriction of sodium by learning to substitute other flavorings. Salt substitutes are useful to some. Because these compounds may be harmful to patients with damaged kidneys, they should be used only with a physician’s prescription.
Many flavoring extracts, spices, and herbs may be used to lend interest to the diet. Usually a dash of spices or a small pinch of herbs is sufficient for most family-size recipes. The flavor should be delicate and subtle rather than strong and overpowering. Meats may be marinated in wine, vinegar, low-sodium French dressing, or sprinkled with lemon juice before cooking. A few suggestions for flavor combinations are provided below.
Meat, Poultry, Fish, Eggs
Beef: bay leaf, lemon juice, marjoram, dry mustard, mushrooms, nutmeg, onion, green pepper, pepper, sage, thyme; currant or grape jelly
Chicken or turkey: basil, bay leaf, lemon juice, marjoram, onion, pepper, rosemary, sage, sesame seeds, thyme; cranberry sauce
Lamb: curry, garlic, mint, onion, oregano, parsley, rosemary, thyme; mint jelly, broiled pineapple
Pork: garlic, lemon juice, marjoram, sage; applesauce, spiced apples, cranberries
Veal: bay leaf, curry, dill seed, ginger, marjoram, oregano, summer savory; currant jelly; broiled apricots or peaches
Fish: bay leaf, curry, dill, garlic, lemon juice, mushrooms, mustard, onion, paprika, pepper
Eggs: basil, chives, curry, mustard, parsley, green pepper, rosemary, diced tomato
Vegetables
Add a dash of sugar while cooking vegetables to bring out flavor.
Asparagus: lemon juice, caraway; unsalted chopped nuts
Green beans: dill, lemon, marjoram, nutmeg, onion, rosemary; slivered almonds
Broccoli: lemon juice, oregano, tarragon
Corn: chives, parsley, green pepper, pimento, tomato
Peas: mint, mushroom, onion, parsley, green pepper
Potatoes: chives, mace, onion, parsley, green pepper
Squash: basil, ginger, mace, onion, oregano
Sweet potatoes: cinnamon, nutmeg; brown sugar
Tomatoes: basil, marjoram, oregano, parsley, sage
Homemade quick breads, biscuits, and muffins may be made by using low-sodium baking powder instead of regular baking powder. For each teaspoon of regular baking powder, it is necessary to use 1 1/2 teaspoons low-sodium baking powder. The salt specified in the recipe should be omitted.
Homemade bread, waffles, and rolls may be made by using yeast and omitting the salt from the recipe. The yeast dough may be rolled out, spread with unsalted butter, and sprinkled with sugar and cinnamon for delicious cinnamon rolls.
*147/234/5*

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(posted in General health | tagged )

CHILDCARE/TRAVELLING WITH CHILDREN: MOTION SICKNESS

Tuesday, May 19, 2009 | 12:50 am

Some children feel nauseated when travelling long distances in a car or by boat. This usually begins around 5 years of age and may last a lifetime. Special medication can be used to prevent motion sickness but should be given strictly according to directions. If your child suffers from motion sickness:

• do not let him read while travelling in the car;

• sit with him up the front of a bus;

• open the window while travelling;

• make sure he always travels facing forward;

• do not smoke in the car;

• do not give him a heavy meal before travelling;

• on a boat, have the child keep his eyes on the horizon as much as possible.

In the car

On a long car journey with your children, make sure that you stop frequently to let them stretch and run a little, or to have a drink or a snack. Children hate being cooped up for long periods of time.

Choose your roadside stops carefully, and keep an eye on your children, particularly if there is a lot of traffic around. Take games and toys along with you that are appropriate for children to play in the car. If your child suffers from motion sickness, it is best for him to avoid reading or writing in the car.

*120\90\8*

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(posted in General health | tagged )

SUPER MARITAL SEX: SEX AND THE HEART: SOME RECOMMENDATIONS OF THUMB TO APPLY TO THE ISSUE OF HEART DISEASE AND SEXUALITY

Monday, May 18, 2009 | 7:03 am

Don’t watch or feel for symptoms. They will get your attention if they occur. If they do (tightness in the chest, chest pain, shortness of breath), don’t panic. Just slow down, hug, rest, and talk. Report these symptoms to your doctor, but remember, many such symptoms are insignificant or not as pronounced as you may think. Always call the doctor, but do not jump to conclusions. Don’t lie there alone and worry. Share with your partner. Your doctor will probably reassure you anyway. If you coming to worry, both of you should watch as the partner with the heart ðãîblems exercises vigorously under carefully monitored medical conditions. Have the doctor explain to you what all the tracings mean. Healing can be takin8 place in the heart even when there are some abnormal findings, even when symptoms persist. Symptoms do not necessarily mean a setback in healing. If you still worry, suggest that the doctor send the spouse with the heart problem home with an ambulatory heart monitor attached. Have sex record when you had sex and any symptoms you might have had, and go together to discuss the results. You will probably be very relieved.

Your doctor will prescribe an exercise program. The days of staying in bed after a heart attack are over. Activity heals, but only at a medically monitored and prescribed rate, and that includes sexual activity.

If you have pain, ask about using nitroglycerin, long-acting nitrate preparations, or other medications. Be sure to ask when and how these medications should be used. Some should be taken at regular intervals, while others should be taken several minutes before sexual activity.

Remember, there is much more to sex than intercourse. Talk with your doctor about all of sex or he or she might assume that sex equals coitus. No single sexual activity is more dangerous than any other.

The spouse with the heart problem does not need a spousal nurse. He or she needs a loving sexual partner who expresses his or her own sexual needs vigorously and honestly. If the patient sees your comfort and freedom, he or she will learn the same approach. The patient must learn to protect himself or herself, and attempts by a spouse to protect the heart patient typically backfire into more fear, loss ot self-esteem, and even resentment. Don’t let any disease take the heart out of your sex life.

*271\97\8*

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(posted in General health | tagged )

YOUR MARITAL HEALTH/SEXUALITY FROM ANOTHER PERSPECTIVE: ELLISONIAN SEX

Monday, May 18, 2009 | 5:18 am

Ellisonian sex, then, is a male-driven, female-responsive sex of intense and rapid sexual energy buildup in the male and slower, more generalized, somewhat less urgent response in the female. Orgasm was the ultimate goal, but touching, particularly for women, was enjoyable if not necessary. The penis and its spontaneous erection was the center of male sexual response, and the clitoris with its connections to the vagina and the uterus was the center of female response. Marriage was a natural manifestation of the desire for prolonged companionship, but might have to be augmented by some type of sexual variety to keep it alive. Men acted and entered, women reacted and received. In spite of this mechanical-sounding emphasis, Ellis was a new romantic who valued closeness and tolerated deviation from “the normal.” Paul Robinson states, “Havelock Ellis is the most unambiguously Romantic of the great modernists … at the heart of his sexual writings stands the same union of physical and emotional energies that one finds in Keats and Schlegel.”

Ellis’s work confronted a guilt and fear about sex that permeated daily living. To save ourselves from what he saw as our innate sexual sickness, the Reverend Doctor Sylvester Graham suggested that we rid our diets of meat, animal products, and all spicy foods. Graham suggested that these caloric corrupters be replaced with, of course, nutritious Graham bread and Graham crackers. He was joined in his concern for the digestive sexual degeneration of American by Dr. John Kellogg, who invented corn flakes to save us from too much snap, crackle, or pop in our sex drive. The first modern perspective on human sexuality and its relationship to intimacy offered a freedom from this type of restrictive, fear-inducing approach to sex. At the same time, however, Ellis’s views about sexual energy, male and female differences in sexual response, and the power of sexual variety are still present today, and they strongly influenced the work of Alfred Kinsey, the pioneer of a second perspective on sexuality.

*97\97\8*

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(posted in General health | tagged )

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