Qualitative Dietary Deficiency

Energy-yielding Nutrients

Deficiency

Carbohydrates. These usually provide the greater part of the calories in a normal diet but no individual carbohydrate is an absolute dietary necessity in the sense that the body needs it but cannot make it for itself from other nutrients. If the carbohydrate intake is less than 100 g per day ketosis is likely to occur.

Fats. With their high caloric value, fats are useful to people with large energy expenditure; moreover they are helpful in cooking and making food appetizing. Though rats need linoleic or arachidonic acids in their diet deficiency

of these essential fatty acids is rare in man. It has been demonstrated in patients who have been fed intravenously for long periods without fat emulsions.

The possible role of cholesterol, fats and different fatty acids in the pathogenesis of atherosclerosis and coronary thrombosis will be discussed later. (Dietary Deficiency)

Proteins. Proteins provide amino acids, of which eight are essential for normal protein synthesis and for maintaining nitrogen balance in adults. These are termed essential amino acids because the body cannot make them for Itself and so must obtain them from the diet. They are methionine, lysine, tryptophan, phenylalanine, leucine, isoleucine, threonine, and valine. There is evidence that histidine and perhaps arginine are needed for growth in infants.

The ‘biological value’ of different proteins depends on the relative proportions of essential amino acids they contain. Proteins of animal origin, particularly from milk, eggs, meat and fish, are generally of higher biological value than the proteins of vegetable origin. Most vegetable proteins are deficient in one or more of the essential amino acids; but it is possible to have a diet of mixed vegetable proteins with high biological value if the principle of supplementation is used. For example cereals, e.g. wheat, contain about 10 per cent protein and are relatively deficient in lysine. Legumes contain around 20 per cent of protein which is relatively deficient in methionine. If two parts of wheat are mixed (or eaten) with one part of legume, a food results which contains 13 per cent of a protein of high biological value. This happens because cereals contain enough methionine and legumes enough lysine to supplement the other component of the mixture.

A deficient intake of protein leads to (a) negative nitrogen balance; (b) wasting of tissues; and (c) fall in plasma albumin. The usual recommended allowance for an adequate protein intake is 10 per cent of the total calories. The minimum requirement is less, around 40 g per day of good biological value protein for an adult.

PROTEIN-CALORIE MALNUTRITION (Dietary Deficiency)

(PROTEIN-E ERGY MALNUTRITION) (Dietary Deficiency)

Aetiology and Classification. Protein-calorie malnutrition (PCM) in early childhood is now regarded as a spectrum of disease. At one end there is kwashiorkor in which the essential feature is deficiency of protein with relatively adequate calorie intake. At the other end is nutritional marasmus which is total inanition of the infant, usually under 1 year of age, and is due to a severe and prolonged restriction of calories and protein as well as other nutrients. In the middle of the spectrum is marasmic kwashiorkor in which children have some clinical features of both disorders.

Table 1

Classification of PCM

	Body weight as percentage of international standard for age	Oedema	Deficit in weight for height
KwashiorkorMarasmic KwashiorkorMarasmusNutritional dwarfing Underweight Child	80-60 <60 <60 <60 80-60	+ + 0 0 0	+ ++ ++ Minimal +

Based on Joint FAO/WHO Committee on Nutrition. 8th Report, 1971 (with modifications in weight/height column).

Some children adapt to prolonged calorie and/or protein shortage by nutritional dwarfism. The most prevalent of all the varieties of PCM is mild to moderate PCM or the Underweight Child (see Table 1).

Children with one form of PCM often shift to another form. Thus a child with mild to moderate PCM may develop kwashiorkor after an infection. When such a child is treated and loses oedema he may look marasmic.

The incidence of PCM in its various forms is high in India and South-east Asia, in most parts of Africa and the Middle East, in the Caribbean islands and in South and Central America. PCM is the most important dietary deficiency disease in the world, affecting tens of millions of children; hence it will be described in considerable detail. (Dietary Deficiency)

Bacterial food Poisoning

Bacterial food Poisoning

Food poisoning includes a number of disorders presenting with diarrhea and vomiting due to acute gastroenteritis developing up to 48 hours after the consumption of food or drink. It is customary not to include under this term the enteric fevers, dysenteries and cholera which are also spread by infected food and drink. In contrast to enteric fever which is relatively uncommon and cholera which has been almost unknown in Britain for the last 100 years, there is an increase in the reported incidence of food poisoning, of which that of bacterial origin is by far the most common type.

Food poisoning may also be due to intestinal allergy, e.g. to shellish, or to children eating unripe fruit or other unsuitable foods. Rarely a poisonous substance may be eaten, e.g. Amanita phalloides, in mistake for a mushroom or a chemical poison in food may be unwittingly consumed. Examples of the latter range from barium carbonate used in baking in mistake for flour, to arsenic or powdered glass administered murderously in the tradition of the Borgias.

Food which has been placed in a container previously used for holding a chemical poison may be contaminated. Placing acid fruit juices in cheap enamel or zinc vessels may result in the liberation of antimony or zinc. Home-made wine kept in glazed earthenware containers may be the source of chronic lead poisoning.

Aetiology. Bacterial food poisoning is usually divided into the infection and toxin types.

INFECTION TYPE. The organisms mainly responsible belong to the Salmonella group whose source is certain birds, cattle and reptiles, such as pet tortoises. The domestic fowl is one of the commonset sources of salmonellae and modern methods of poultry husbandry involving battery-rearing and deep-freezing of carcasses encourage the spread and transmission of infection, the organisms surviving in the frozen birds. Salmonella typhimurium causes at least three-quarters of the cases of food poisoning of the ‘infection’ type in Britain. Food may be contaminated with infected excreta of mice ot rats, or infection may be transferred by flies or by human carriers employed in the handling of food. The size of the infecting dose of bacteria bears a close relationship to the speed of onset of symptoms and to the severity of the illness. This indicates the dangers of bacterial multiplication which may take place when food is contaminated and thereafter remains warm for many hours or days. The types of food which are particularly likely to be affected are twice-cooked meat dishes, stews, gravies, soups, custards, milk and synthetic cream. The danger of food poisoning is greatly reduced if such foods are kept in a refrigerator. Ducks tend to be carriers of salmonella organisms in the oviduct and alimentary tract, and duck’s eggs are not suitable for the preparation of lightly cooked foods. Hen’s eggs are rarely affected.

TOXIN TYPE. Such poisoning is most commonly caused by the enterotoxin produced by Staph. aureus. This frequently originates from a food handler who may be a carrier or suffering from a septic lesion and so contaminates food. Incubation under suitable conditions of temperature leads to growth of the organism and production of toxin which is relatively heat resistant and may not be destroyed by cooking. Strains of clostridium welchii, many of them relatively resistant to heat, may contaminate certain foods, particularly meat. Pre-cooking of stews and pies may not destroy all the spores and the keeping of such food, even when followed by heating before consumption, will lead to the formation of toxins which can give rise to gastroenteritis, sometimes severe. Other bacteria (e.g. Streptococcus and Bacillus) may contaminate food without obvious spoilage and may also cause mild gastroenteritis.

Outbreaks of food poisoning affecting large numbers of persons occur in canteens, restaurants, hospitals and other institutions.

Clinical Features.(Bacterial food Poisoning)

The simultaneous occurance of symptoms in more than one member of a household or institution often simplifies diagnosis. The incubation period is a useful pointer to the aetiology. If vomiting starts within 30 minutes of the ingestion of suspected food, it is likely to be due to a chemical poison; if it arises 12 to 48 hours later, it is probably due to a Salmonella infection. The incubation periods of staphylococcal and clostridial food poisoning are usually intermediate between these extremes being from one to 12 hours.

The symptoms in any single outbreak vary in severity depending on the type and amount of the poisonous substance ingested. The principal symptoms are nausea, vomiting, diarrhea and central abdominal colic. Staphylococcal food poisoning may be associated only with vomiting while diarrhea and abdominal pain are more prominent with Cl. Welchii toxins. In severe cases there may be prostration, collapse and signs of dehyderation. In the chemical and toxin types of food poisoning the onset tends to be sudden and severe and the patient may rapidly become shocked. Recovery however usually occurs within 24 hours. In the infection type, symptoms develop more slowly and there is usually pyrexia and toxicity. The patient may be ill for several days. The stools are watery and offensive, and may contain blood and some mucus, in contrast to bacillary dysentery where there is also pus.

A rare cause of bacterial food poisoning is the ingestion of one of the most potent poisons known to man, namely the toxin produced by Cl. botulinum. Imperfectly treated tinned food or preserved fish may be contaminated with the organism and be the source of the toxin. The clinical features differ from all other types of bacterial food poisoning and consist chiefly of vomiting, constipation, thirst and the secretion of viscid saliva and of ocular and pharyngeal pareses and aphonia.

Diagnosis. (Bacterial food Poisoning)

A specimen of the patient’s stool or vomit together with the suspected food, if available, should be sent for culture. Organisms of the Salmonella group can usually be readily isolated. In more severe cases blood should be sent for culture. Notification of Salmonella infection and other types of food poisoning is compulsory in Britain.

Food poisoning must be differentiated from acute surgical abdominal emergencies especially in children.

Treatment. Most cases are miled and can be treated at home. Solid food should be withheld and the patient instructed to take fluids only. A quarter teaspoonful of table salt added to one pint of water flavoured with a small quantity of fruit juice provides a satisfactory oral replacement solution. Patients who are severely ill, collapsed or dehydrated require intravenous fluid therapy.

Symptoms normally pass off spontaneously in a day or two. When acute symptoms cease, semi-fluid low-roughage diet may be taken containing bread, butter, eggs, fish, softpuddings and jellies. To control diarrhea, kaolin mixture may be given in 10 ml doses every two to four hours. Codeine phosphate 30 mg six-hourly is also useful.

Antibiotics should not be given for acute diarrhea and vomiting as they are ineffective and frequently exacerbate symptoms. If salmonella bacteraemia is suspected or confirmed, ampicillin, 1 g every six hours should be given by intramuscular injection.

If the poisoning is thought to be due to a chemical or a poisonous food, the patient’s stomach should be washed out with tepid water, using the technique described onward.

Prevention. In salmonella food poisoning the carrier state persists on the average for about 14 days after infection but may be much longer, and the patient must not be allowed to handle food until he has stopped excreting the organism. A reduction in the high incidence of food poisoning can best be achieved by improving the standards of personal hygiene, especially in those handling food, and by stressing the importance of hand-washing after using the lavatory. Increasing facilities for low temperature storage of food which has to be kept for some hours or days before being consumed is of the greatest importance. It is essential to keep frozen poultry at room temperature for at least eight hours before cooking or pathogens at the centre may survive unharmed. (Bacterial food Poisoning)

Healthy Heart, Cholesterol Lowering Food for Disease free Life

A healthy heart leads to a healthy life free of disease. This article has covered a list of foods that are very helpful in reducing cholesterol level. Taking proper care of your health is above all that you do in your daily schedule so try to follow them - for you and your family happy.

High blood cholesterol problem may result in complications such as heart problems critics. You can have high blood cholesterol due to several reasons. You can control some of these factors, but some of them can? It is controlled. The life is one of the most important factors leading to high blood cholesterol. But sometimes it is seen that the people going through a perfectly healthy lifestyle may suffer from high blood cholesterol. This may be a hereditary factor that is one of the major factors influencing cholesterol in our blood.

Normally, our body produces a certain amount of cholesterol. Individuals, who are predisposed to high risk blood cholesterol problem, can only depend on medications prescribed by an expert in health www.ayurvedicherbalcure.com/Herbs/arjuna.html . They need to maintain a healthy lifestyle and have a balanced diet, including plenty of healthy foods that reduce cholesterol. They need to work on some important factors such as weight management and diet.

You should choose food that helps. Do not take food that contains saturated fat, Trans fat and cholesterol. You can completely eliminate these elements from your diet, or can at least minimize the consumption of it.

Avoid sitting in front of the computer for a long period of time. If your daily routine lacks physical activities, you're running a great risk for various complications, such as high cholesterol. Even doing some simple exercises, like walking for an hour daily can help you manage your cholesterol level. If you can include in your daily exercise, you're on the way to manage blood pressure and triglyceride level.

If you have high blood cholesterol, you need to regularly check your body weight. If you are overweight, you should immediately take appropriate measures to lose weight.

If you are having you should increase your intake of foods high in soluble fiber. Soluble fiber helps to manage high cholesterol by absorbing it and then extracting the body through the digestive system. Foods that are good source of soluble fiber are apples, blackberries, oranges, apricots, peas, beans, broccoli, grapefruit, and sweet potatoes.

The Omega 3 fatty acids are to a significant level. You should take mackerel, salmon, sardines, and many others in your daily diet to meet the demand for omega 3 fatty acids in your system. Omega 3 fatty acids help in minimizing cardiovascular problems. If you do not want to have as much fatty fish, you can replace the foods that rely on lower cholesterol, such as walnuts, soybeans, and ground flax.

Apart from these, you can also add sterols in your diet. Sterols are nutritional substances found in plant cell membranes. Pistachio nuts, sunflower seeds, wheat germ and contain high amounts of sterols. Sterols actually resemble the chemical structure almost identical to cholesterol. If you take sterol in your diet, cholesterol claims for access to receptors located in the small intestine. Thus, it minimizes the production of cholesterol by effectively blocking their access to the small intestine. Hence, results in decreased cholesterol level in the body.

I have mentioned a good list of foods in this article that may help to lower high blood cholesterol level. So, take care of your diet and live a healthy life.

Important Notice: We are not intended to provide health advice in this article and are for general information. Always seek the insights of a qualified health professional before embarking on any health program.

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By:- Adrianna smith

Early Signs of Pregnancy 

A lot of couples who are hoping to have a baby will likely react to the very slightest discomfort that they hope might signal that the woman is finally pregnant. Of course, pinpointing pregnancy so early on is typically not easy, as some of the discomfort that the lady feels may be credited to something other than pregnancy.
A lot of couples who are hopeful to have a baby will likely react to the very slightest discomfort that they hope might signal that the woman is finally pregnant. Of course, pinpointing pregnancy so early on is typically difficult, as some of the discomfort that the lady feels may be attributed to something other than pregnancy. The following symptoms may be present but they may not necessarily be caused by a pregnancy:
1. Tiredness or fatigue – Extreme tiredness can happen as early as a week following conception. But this is more difficult to use as a gauge because fatigue can be caused by many other things, such as lack of sleep or a general physical exhaustion from a busy week or weeks.
2. Breast tenderness – You may notice your breast starting to feel tender, swollen, or simply more sensitive than usual. Although this also happens just before you get your period, as a sign of pregnancy, it can happen about one to two weeks following conception.
3. Irritability or moodiness – Hormonal changes can cause mood swings that are more pronounced than usual. Of course, you need to remember that you may also feel moody when your period is approaching. As such if this is a symptom of pregnancy it is usually disregarded in the absence of the other symptoms.
4. Headaches – Raised levels of hormones may cause headaches; as such, some women experience headaches early on in a pregnancy. But this symptom is a little too common to attribute directly to a pregnancy, as it can be caused by any myriad of factors.
5. Food cravings – Although cravings are generally joked about around someone who is pregnant, it may not be an accurate gauge of pregnancy minus other confirmation. After all, a woman may just happen to have a mood-directed choice of food, such as yearning for comfort food like ice cream during a particularly depressed moment. Women happen to be among the most emotionally-driven eaters, so this may not be too accurate.
6. Frequent urination – Some women experience a need to empty their bladders more frequently than usual. However, this is usually not noticed as a sign as many women feel it to be too normal a change.
However, there are also early signs that are more definite in telling you that you are indeed pregnant. Among these are:
1. Missing a period – This is typically the main sign that women take before they buy a pregnancy test. Of course, an important thing to remember is that you may also miss your period, if you have it regularly, due to hormonal changes in rare cases, such as if you suddenly lost a lot of weight. It may also happen when you are taking anti-pregnancy pills, as some of them curb the production of egg cells, which eventually result in amenorrhea.
2. Morning sickness or nausea any time of the day – This is the most commonly portrayed symptom for pregnancy in movies and books. This is because you don’t normally undergo this when you are about to have your phase except for severe cases of dysmenorrhea. This can happen at about two to eight weeks following conception as your hormone levels reach top levels than usual.
3. Implantation bleeding – When the fertilized egg cell is implanted onto the uterus, some women knowledge implantation bleeding. This typically happens between six to twelve days following conception, and the bleeding is not as pronounced as a period. It is aptly described as spotting.
Although these are typical early signs of pregnancy, with the immunity of a missed period, not all women experience them, as every pregnancy is exclusive So if you find yourself experiencing most, if not all, of these symptoms, it might be the best time to buy yourself a pregnancy testing kit. If you don’t and yet confirm yourself to be pregnant, do not be anxious, as these signs are in no tactic an sign of a healthy pregnancy. In any case, just celebrate the new life rising within you and enjoy each step of the journey as you welcome a new member into your family.

Leptospirosis

 

Leptospirosis

(Leptospirosis) Weil’s disease, an infection associated with jaundice and caused by invasion with Leptospira icterohaemorrhagiae, was the first leptospiral infection to be recognized in man. It was not long before it was discovered that the rat is the natural host and that the mode of spread is by contact with rat’s urine containing the organism, which can penetrate the skin or mucosae.
(Leptospirosis) Subsequently over 100 serotypes of leptospires have been identified, many of which have been shown to cause disease in man. The natural hosts of most of these types are small wild rodents, but some may also occur in animals such as dogs and pigs. In Britain only two serotypes, namely L. icterohaemorrhagiae and L. canicola, have been shown to cause human disease, but other serotypes have been isolated from wild rodents. The spread of these infections is usually by contamination with infected animal urine, and fish cleaners, farm-workers, veterinarians and vagrants are those most at risk; immersion in canals or stagnant water may also result in sporadic infection and in such instances the disease may present as lymphocytic meningitis due, probably, to the entrance of the leptospires through the conjunctivae. (Leptospirosis) Infections due to leptospires other than L. icterohaemorrhagiae are not often associated with jaundice and diagnosis frequently involves differentiation from other causes of pyrexia of unknown origin. The first step is to establish whether or not antibody to leptospiral antigen is present and this may be rapidly carried out in most laboratories. The isolation and identification of the causative organism from body fluids such as blood or urine is more difficult and time consuming.
Pathology. In patients dying from laptospirosis, there has usually been a combination of hepatic, renal and cardiac failure. The changes in the liver are non-specific; in severe cases, there may be centrilobular and even massive necrosis. Oedema and inflammatory exudate lead to intralobular biliary stasis. In the kidneys, the glomeruli are usually spared, but the tubules are affected and contain haemoglobin and myoglobin casts. The main findings in the myocardium are focal haemorrhages, interstitial oedema and cellular infiltration. A similar picture is seen in skeletal muscle. If meningitis is present, there is thickening of the meninges due to inflammatory exudate.

Clinical Features.(Leptospirosis)

(Leptospirosis) The average incubation period is 10 days, the range being 4 to 21 days. An unknown, but significantly high proportion of infections are subclinical or may cause a mild undiagnosed fever. In the more severe infections the first or septicaemic phase lasts about a week. Usually the clinical illness begins abruptly with headache, severe myalgia, pyrexia, conjunctival suffusion, anorexia and vomiting. Infrequently, there are skin rashes or petechiae and enlargement of the liver and spleen.
In the second phase, sometimes termed the toxic or immune phase, leptospiral antibodies appear in the blood. The temperature falls by lysis and is usually normal for two or three days. In the majority of patients, there is further pyrexia for a few days and transient meningism followed by prompt recovery. In other cases, during this phase, hepatitis, tubular necrosis, myocarditis and meningitis may occur. The cause of these serious complications is uncertain but cell damage from immune complexes is a possible explanation.
Hepatitis is indicated by epigastric pain and tenderness in the right upper quadrant of the abdomen and the appearance of jaundice, usually accompanied by dark urine. There may or may not be pallor of the stools. In severe cases, jaundice deepens, there is marked anorexia and vomiting and there is a haemorrhagic tendency. The patient may worsen and show all the features of acute massive liver necrosis. Renal tubular necrosis may lead to acute renal failure. Myocarditis is suggested by tachycardia, fall in blood pressure and cardiac enlargement. The development of profound hypotension, arrhythmias and cardiac failure are ominous signs. Meningitis causes severe headache, neck stiffness and a positive Kernig’s sign. Haemorrhagic pneumonia and iritis are infrequent complications.
By the third and fourth week of the illness, the majority of patients enter the third or convalescent phase. The average case has a post-infective debility which gradually improves. When there has been serious involvement of the liver, kidneys and heart, mortality is in the region of 15% to 20%. Those who recover, do so completely. There is gradual clearing of jaundice, the urine output improves with regression of uraemia, the blood pressure rises, the heart returns to normal size and any signs of cardiac failure disappear. During the third phase, the case untreated with penicillin may show a temporary return of muscle pain with pyrexia (secondary fever). The reason for this is not known.
(Leptospirosis) Laboratory Data. Most patients with leptospirosis show a polymorphonuclear leucocytosis. When there is liver involvement, the liver function tests indicate a mild hepatocellular jaundice with and intrahepatic obstructive element; bilirubin and urobilinogen are present in the urine. In patients with renal failure the urine contains protein, red blood cells and cellular and granular casts; in severe cases the rise in blood urea is progressive. In myocarditis there is electrocardiographic evidence of conduction disturbances and arrhythmias. Meningitis is characterized by an increase of lymphocytes in the cerebrospinal fluid with little or no rise in protein; xanthochromia may be observed in the jaundiced patient. Apart from the few patients developing severe haemorrhagic pneumonia, scattered opacities’ probably due to haemorrhage are seen on radiography of the chest in 10 to 20% of cases.
The diagnosis is made by culturing the organism from the blood in the first week or from the urine in the second and third weeks. Alternatively, blood or urine specimens may be inoculated into a guinea-pig. From the second week onwards, specific leptospiral antibodies in rising titre may be demonstrated in the blood. The serum antibody titres may not however reach diagnostic levels in those cases treated promptly.

Treatment. (Leptospirosis)

Leptospirosis are sensitive to penicillin in vitro. Penicillin is effective therapy in man provided it is given early enough and in adequate doses; it shortens the average illness, reduces the incidence of severe complications and abolishes secondary fever. Doubts about the usefulness of penicillin in the past arose because treatment was being initiated too late in the infection. Benzylpenicillin must be given as early as possible in the leptospiaemic phase in a dose of 300 mg six-hourly for seven days and thereafter twice daily for a further seven days. In 80 to 90% of patients receiving penicillin, there is an aggravation of symptoms and a brisk rise of temperature four to six hours after the first injection and lasting for about 18 hours. This is sufficiently consistent to give valuable indirect evidence of the correct diagnosis. Appropriate fluid replacement, parenterally if necessary, is important during the period of acute illness. In severely affected patients supportive treatment for acute massive liver necrosis, acute renal failure, arrhythmias and cardiac failure may be required. (Leptospirosis)

Mumps

Mumps is caused by a virus which spreads by droplet infection and affects

mumps

mainly children of school age and young adults. The infectivity rate is not high and there is serological evidence that 30-40% of infections are clinically inapparent. Most cases occur in the spring. The incubation period is about 18 days. A quarantine period is not necessary: contacts should be watched for the first sign of disease from the 12^th to the 28^thday after exposure.

Clinical Features.(Mumps)

Malaise, fever and some pain near the angle of the jaw is soon followed by tender swelling alone is often the first feature. The submandibular salivary glands may also be involved. The swollen glands subside in a few days, and may be succeeded by swelling of a previously unaffected gland. Orchitis occurs in about one in four males who develop mumps after puberty; it is usually on one side only, but if it is bilateral, sterility may be a sequel. Obscure abdominal pain may be due to pancreatitis or oöphoritis. Acute lymphocytic meningitis is another mode of presentation. Encephalomyelitis is rare. If such conditions are due to mumps, they are accompanied by a lymphocytosis. It is also of great diagnostic value in such obscure cases to know that mumps is epidemic in the district at the time.

Diagnosis.(Mumps)

Most cases of mumps can be diagnosed on clinical grounds alone. But the diagnosis can be confirmed in doubtful cases by the demonstration of specific antibodies, or the virus may be cultured from the saliva, or from the cerebrospinal fluid in meningitis. Suppurative parotitis is distinguished by the circumstances of onset in an old, frail, ill, febrile or dehydrated patient in whom oral hygiene is poor, and confirmed by obtaining pus from the parotid duct. Calculous obstruction of the parotid duct is rare; it is relatively common in the submandibular duct where the stone can often be felt. Sarcoidosis may cause enlargement of the parotid glands and is usually painless and accompanied by other signs especially uveitis.
Treatment. Oral hygiene is important when the mouth is very dry due to lack of saliva. Difficulty in opening the mouth may necessitate feeding through a straw. Apart from the relief of symptoms as they appear, no other treatment is necessary. Orchitis can be relieved by the administration of prednisolone for a few days without apparent danger of dissemination of infection. Cases of mumps should be isolated until the gland last affected has subsided.

Healthy Body Tips

Ten Tips Help You Maintain A Healthy Body

1. Obviously, a better you on the external starts with a better you from the indoor. Good choices in food are serious. Try to stay away from foods, sauces, dressings, etc. that are high in saturated fat, high calories, empty calories, sugar or any derivative, fried, etc. High fiber foods, fruits, vegetables, water, poultry, fish, lean meats. Eating red meat isn't a sin, just eat it in moderation.
2. Drink as much water as you can, as this is a natural diuretic and flushes the body of toxins and keeps the plumbing working great. If you absolutely hate the taste (yes some think that water has taste) of water, then mix with a flavored low calorie powder mix up
3. Vitamins; once a day, every day. Vitamin E has been known to help ease hot flashes in menopausal women. Vitamin E, however is also a blood thinner so double make sure with your doctor first, especially if you are on Coumadin or Plavix. Overdosing on Vitamin E is also not good, so watch your dosage.
4. The Marlboro man doesn't really love you. Please if nothing else, quit smoking or do not start. Smoking chokes off the arteries and veins in your body thereby stopping the flow of oxygen and blood to your legs. Smoking leads to many types of cancer; breast, pancreatic, lung, etc. Not to mention other types of vascular diseases.

5. Exercise a day keeps your body in good shape. No substance how you do it, just do it. Walk before work or after work, walk in the park with the dog. Play outer with your kids. Exercise doesn't have to be grueling, boring or a chore. Play catch with the kids. Garden, run the vacuum. Pilates, Yoga, dancing are all great ways to get exercise.
6. Easier said than done, keeping stress out of your life is pivotal. Stress causes ulcers, eczema, psoriasis, etc. Try to find one thing to laugh about during the day. Reach out to friends for a rapid phone call. Smell flowers. Take a girl's day/night and go to the spa for a mini-massage or manicure/pedicure. Check out the newest chick flick or joke movie playing. Relax in a nice bubble bath or read a book. Even better, you could go to a comedy club. Billy Connolly is on tour at the moment.
7. Much more is known these days about skin cancer and sun stroke and the use of SPF products. While the sun provides us with vital Vitamin D, it also creates free radicals in our body, causing skin cancer or melanoma. It also makes the skin wrinkle. Make sure you apply UV protective products frequently throughout the day if you are sun worshiping, swimming, exercising or just about anything outside

8. Show me your pearly whites! As significant as it is to eat healthy and exercise, maintaining our mouth is also vital. First of all, who wants to look at anyone with all sorts of gunk peeking out from between their teeth or with missing teeth? Dental appointments, at least every six months but definitely once a year, should be as mandatory as your cup of morning coffee.
9. Say ?ah? please. A yearly visit to your physician or gynecologist for a physical and general work-up is critical in keeping healthy. Woman, starting at age 20, should have yearly Pap tests to screen for cancers and STDs (sexually transmitted diseases). Of course, person examination of the total body is a good indicator of healthiness.
10. No glove, no love. Any age, any sex, anytime, anywhere. Once a woman becomes sexually active whether in a monogamous relationship or the riskier many partner sex, condoms are strongly confident. Condoms are a huge way to keep pregnancy and STDs at a secure distance. There are lots of different types of condoms available to outfit anyone's taste and there is no excuse in the world for not using them, if you are married to your partner.

Staphylococcal Infections (pneumonia)

Staphylococcal Infections

pneumonia

Staph. pyogenes (coagulase-positive staphylococcus – syn. Staph. aureus) is responsible for a wide variety of suppurative conditions such as infected lacerations, styes, boils, carbuncles, abscesses, osteomyelitis, pneumonia, necrotizing enterocolitis and bacteraemia with pyaemic abscesses. Infection is derived from human or sometimes animal sources and the organisms can be grown from the nasopharynx and skin of up to 30% of healthy persons. The staphylococcus is readily spread from these sites and from clothing to contaminate the dust in which it survives in the dry state for weeks or months.

(pneumonia)

(pneumonia) In hospital this organism is an important cause of wound infection, pneumonia and neonatal sepsis. Under suitable conditions it multiplies freely in food and milk and so is an important cause of food poisoning. However many infections, particularly boils, carbuncles and abscesses, are due to autogenous infection.
Strains of Staph. pyogenes resistant to antibiotics have increased in number since these drugs were introduced. Such strains are more commonly acquired in hospital and may give rise to small epidemics of infection. Elsewhere the majority of strains are sensitive to antistaphylococcal antibiotics although the production of penicillinase by many precludes treatment with benzylpenicillin. Necrotising enterocolitis is usually the result of the unrestricted growth of drug-resistant staphylococci in the gut following the suppression of other organisms by chemotherapy. The diarrhea, dehyderation and peripheral circulatory failure may be so severe as to resemble cholera.

(pneumonia) Boils

are satisfactory treated with an occlusive dressing or the local application of antiseptic agents. When the severity of the disease warrants antibiotic therapy, the choice depends on whether the infection has been acquired inside or outside hospital. In the later case the organism may be sensitive to penicillin. If the therapeutic response is not satisfactory within 48 hours, the sensitivity tests should be carried out. Since the majority of staphylococcal infections acquired in hospital are resistant to the commonly used antibiotics, the organism should be submitted to sensitivity tests at the outset. If the patient is seriously ill treatment should be commenced with cloxacillin, unless the patient is known to be allergic to the penicillins when lincomycin or clindamycin should be given. All possible care must be taken to prevent the spread of staphylococcal infection and infective patients should be isolated and barrier-nursed. (Staphylococcal Infections (pneumonia)

Nutritional Factors in Disease

nutritional factors in disease

THAT disease might be due to lack of some essential factor had little place in the thinking of 50 years ago. Consequently the concept of deficiency diseases, nutritional and endocrine, grew in the present century. As deficiency diseases came to be recognized and understood, the next step was the realization that lack of nutritional and endocrine factors affects primarily the chemistry of the body. Disease resulting from a ‘biochemical lesion’ and structural changes are late effects, secondary to change in function.

This revolution in medical thought had profound practical consequences. The great nutritional diseases that flourished within the lifetime of some doctors still in practice have now vanished wherever medical knowledge has been linked
with proper administration of food supplies. Florid rickets is now a clinical curiosity in Britain, yet in the streets of our big cities we still see elderly people, bandy-legged, stunted and pigeon-chested, who carry the scars of it. Pellagra, prior to 1940, affected tens of thousands of poor country people in the southern states of the USA; better knowledge of nutritional needs and, above all, improved economic circumstances have largely swept it away. The classic nutritional
diseases occur only in situations where there is a failure both of food supplies and medical care which regrettably is still the case in many parts of the world. Even in the USA, the richest country in the world, probably several million people are suffering from undernutrition or malnutrition. Those particularly liable to be affected are Negroes, Indians and ‘poor whites’ who, because of lack of education, physical or mental handicaps, alcoholism or drug addiction, are unable to obtain regular employment. It is these classes of people all over the world who tend to have large families and it is not surprising that nutritional disorders are especially liable to develop in the fourth and subsequent children.

Even in times of severe food shortage, proper application of medical knowledge can do much to overcome the worst effects of qualitative dietary deficiencies; medicine can deal with beriberi, scurvy and pellagra, but has no direct means of treating the effects of underfeeding-undernutrition. Consequently lack of sufficient food continues to be a most serious cause of ill-health in many underdeveloped regions.

The present world population is estimated to be more than 3,500 million and increasing by 70 million per year. In the absence of major catastrophes there will be more than twice as many inhabitants in the world by the year 2000 as there are today. This is not due to an increase in human fertility but is caused almost entirely by a remarkable reduction in the death rate. The greatest threat to the well-being of mankind is this explosive population growth rate. One-third of the world’s population receives less than 2,000 kcal/head/day. Agricultural production is hampered by bad climates, soil erosion, lack of fertilizers, antiquated farming methods, political upheavals and war. This situation will steadily deteriorate unless national programs of population control and family planning based on modern contraceptive techniques are evolved and effectively put into operation. In addition, food production must be greatly increased by the use of high-yielding strains of rice, wheat and maize.

 Aetiology of Nutritional Disorders

There are five essential causes of nutritional disorders:

I. Quantitative Dietary Deficiency. Not enough food results in undernutrition or when more severe, frank starvation.

2. Qualitative Dietary Deficiency. Wrong food results in malnutrition. The term ‘malnutrition’ should be restricted to those nutritional disorders, e.g. rickets and scurvy, which are due to lack of specific chemical components (nutrients) of a proper diet.

3. Quantitative Overnutrition. Too much food results in obesity.

4. Qualitative Overnutrition. This is due to too much of one food component, e.g. hypervitaminosis D.

5. Effects of Natural Toxins in Foods. Some foods contain small amounts of toxic substances which can lead to disease if a person or community has to rely too heavily on a single foodstuff, e.g. lathyrism.

Social and Economic Causes of Nutritional Disorders.

Even in countries where food, ample in quantity and quality, can be purchased, nutritional disorders arise because of poverty, prejudice, ignorance or bad housekeeping often caused by bad housing. The old, the solitary and children are most often affected.

Pathological Causes of Nutritional Disorders.

Even with an ample income, an adequate home and a knowledge of dietetics, a patient may develop a nutritional disorder through some other disease which ‘conditions’ (facilitates) it in one or more of the following ways.

DEFECTIVE INTAKE OF FOOD. (a) Loss of appetite may be an important symptom of organic disease, e.g. cancer of the stomach, and also of psychogenic disease, e.g. anorexia nervosa. (b) Persistent vomiting from any cause. (c) Food fads, e.g. in very strict vegetarians (vegans). (d) Alcohol provides calories but no essential nutrients. Chronic alcoholics suffer from malnutrition more often than undernutrition. (e) Unbalanced therapeutic diets, e.g. diets for digestive diseases may lack ascorbic acid unless care is taken to provide it. (f) Prolonged parenteral feeding with intravenous glucose after surgical operations may precipitate acute deficiencies of the vitamin B complex.

DEFECTIVE DIGESTION AND ABSORPTION. (a) Achlorhydria is a contributory factor in the causation of iron deficiency anaemia. (b) Steatorrhoea limits the absorption of fat-soluble vitamins and calcium. (c) Intestinal hurry due to surgical short circuits, etc. may impair digestion. In starving people the ingestion of unsuitable foods often causes intestinal hurry and intensifies their plight. (d) Antibiotics, if their administration is prolonged, may interfere with the production of vitamins synthesized by intestinal bacteria.

DEFECTIVE UTILISATION. (a) Cirrhosis of the liver may interfere with the proper utilization of ingested nutrients, e.g. of protein and vitamin K. (b) Malignancy, in some unknown way, may produce a state of undernutrition despite an adequate diet. The same may be true of tuberculosis and other prolonged infections. (c) In renal failure vitamin D is not converted to the active metabolite. (d) Some drugs, e.g. anticonvulsants, are antagonists of folate and of vitamin D.        ‘

LOSS OF NUTRIENTS FROM THE BODY. (a) In the nephrotic syndrome there is loss of protein in the urine. (b) In diabetes mellitus uncontrolled glycosuria causes undernutrition. (c) In excessive menstrual bleeding (menorrhagia) secondary iron deficiency anaemia is common. (d) In severe or chronic diarrhea potassium is lost.

INCREASED NUTRITIONAL NEEDS. (a) In pregnancy, lactation and adolescence (especially after an Illness in the last named), and for those engaged in hard physical work, particularly in cold climates, the usual diet may be insufficient. (b) In fevers and hyperthyroidism the increased metabolism calls for more calories. (c) After burns, fractures and major surgery, there is an increased catabolism of protein and ascorbic acid which cannot be replaced until convalescence begins.

Although nutritional disorders are often precipitated and sometimes caused by such conditioning factors, the prime cause is usually a diet deficient in one or more nutrients. It is therefore poor practice to prescribe a single nutrient (e.g. a vitamin) without first looking for evidence of other deficiencies and thereafter taking measures to improve the diet. (Nutritional Factors in Disease)

THE PREVENTION OF INFECTION

PREVENTION OF INFECTION

The control of infection is largely based on three concepts:
1.      The host is separated from the parasite. The oldest known public health measures employed isolation of the infected patient (source isolation) which remains an extremely important method of preventing the spread of infection, including that occurring in hospital. Isolation is carried to its its most sophisticated development in pathogen free units (protective isolation) for the care of patients who are particularly prone to infection, e.g. those suffering from leukaemia under treatment with cytotoxic and corticosteroid drugs. The elimination of a disease from community by finding, treating and isolating the sources of infection is an ideal which should always be vigorously pursued and it has met with considerable success in health campaigns against smallpox and tuberculosis.

Infectious Diseases

Infectious Diseases

Diseases due to infection are prevalent throughout the world. This is especially the case in tropical countries where insect-borne diseases are common and in underdeveloped areas where standards of hygiene and nutrition are low. Almost half of all deaths in developing countries occur in children under the age of 5 from a combination of infection and malnutrition. The main groups of organisms involved are metazoa, protozoa, fungi, bacteria, mycoplasmas, rickettsiae and the viruses. Infections due to metazoa and protozoa occur mainly in tropical areas; thus helminthic infections, malaria, amoebic dysentery, sleeping sickness and leishmaniasis are common diseases in tropical Africa, Central and South America and large parts of Asia but are relatively rare elsewhere. Fungi which cause ringworm of the skin and Candida which cause thrush infections are Blastomyces, Histoplasma and Coccidioides are greatly restricted in their geographical incidence.

The Aminoglycoside Antibiotics antibiotics

The Aminoglycoside Antibiotics

antibiotics

Streptomycin, Kanamycin, Gentamicin, Neomycin, Framycetin and Tobramycin

These have similar chemical structures, pharmacological actions and adverse effects. They are not absorbed and for systemic treatment must be given by injection.

The outstanding property of streptomycin is its bactericidal effect on the tubercle bacillus. It is given in conjunction with para-aminosalicylic acid (PAS) and ionized and this triple therapy prevents the emergence of resistant strains. For long-term therapy the daily dose of streptomycin should not exceed 1 g. The chemotherapy of tuberculosis is discussed later on. Its use in infections due to Gram-negative bacilli is restricted by the rapid development of bacterial resistance. When infective endocarditis is due to an organism relatively resistant to penicillin, such as Strept. faecalis, good results may be obtained by combining streptomycin with large doses of benzylpenicillin or ampicillin.

Kanamycin is active against many Gram-negative bacilli and resistance develops much more slowly than with streptomycin. It should be reserved for the treatment of serious infection such as peritonitis or bacteraemia due to Gram-negative bacteria, e.g. Esch. coli or Proteus species. It is also used in the treatment of gonorrhoea due to organisms of reduced penicillin sensitivity.
The dose should not normally exceed 250 mg six-hourly by intramuscular injection.

Gentamicin has a range of activity similar to kanamycin but has the very important additional advantage of being effective against Ps. aeruginosa (Ps. pyocyanea). It is also active against penicillin-resistant staphylococci but inactive against streptococci and most anaerobic organisms. The dose depends on renal function and the age and weight of the patient. Up to 5 mg per kilogram body weight per 24 hours in divided doses is required for serious infections but 2 mg per kg is sufficient for uncomplicated urinary tract infections. Tobramycin is a new aminoglycoside which is more active than gentamicin against Ps. pyocyanea and is possibly less ototoxic.

Neomycin is too toxic to be given parenterally but local applications containing neomycin are used in infections of the skin and eye. Neomycin is used for the pre-operative preparation of the large bowel and also in hepatic encephalopathy to reduce the numbers of colonic bacteria.

ADVERSE EFFECTS (Aminoglycoside)

The outstanding toxic effect of all the aminoglycosides is on the eighth cranial nerve. With streptomycin and gentamicin the vestibular division is initially affected with resultant vertigo and incoordination. Later, deafness may also occur. Kanamycin tends to cause deafness first while neomycin is much too ototoxic for systemic use. The ototoxicity of the aminoglycosides is directly proportional to the age of the patient, the serum level of the antibiotic and the duration of administration. The aminoglycosides are principally excreted from the body by the kidneys and the risk of ototoxicity is increased if there is any impairment of renal function. Consequently these antibiotics must be given with great caution to any patient with renal disease and where possible serum levels of the antibiotic should be monitored and the dose adjusted accordingly. Sensitivity rashes and fever occur in about 5 per cent of patients treated with streptomycin. Desensitization is indicated if it is essential to continue with the antibiotic. Application of neomycin to the skin may cause hypersensitivity.

Cycloserine

Cycloserine is a bactericidal antibiotic used in the treatment of urinary tract infections due to Esch. coli. The adult dose is 250 mg orally twice daily for a fortnight. Overdosage or normal dosage in the presence of impaired renal function may cause drowsiness or epilepsy. Recurrent urinary tract infection with Esch. coli may be prevented by long-term treatment with 125-250 mg cycloserine on alternate days.

The Polymyxins

The most important member of this group of antibiotics is polymyxin E (Colistin). It is bactericidal against many Gram-negative bacilli and all strains of Ps. aeruginosa.

Colistin sulphomethate. This is given by intramuscular injection in a dose of 1-3 million units eight-hourly depending on the weight of the patient and renal function. Colistin is sometimes prescribed orally in Esch. coli gastroenteritis of infants but the principal indication is pseudomonas infections of the renal tract. All polymyxins are nephrotoxic and may also cause paraesthesiae and dizziness although these side-effects are rare with colistin.

Nitrofurantoin and Nalidixic Acid

These two unrelated chemotherapeutic agents are indicated only for the treatment of infections of the urinary tract and are not effective in other conditions. They are active against the common Gram-negative bacilli such as Esch. coli and Proteus and are administered by mouth. The dose of nitrofurantoin is 100 mg three or four times a day and that of nalidixic acid 1 g three times a day. Nausea and vomiting are common during nitrofurantoin therapy while photo-sensitivity skin reactions occasionally occur with nalidixic acid. Both drugs are potentially neurotoxic. Nitrofurantoin can cause peripheral neuropathy especially if there is renal failure and nalidixic acid may produce increase in intracranial pressure in babies. (The Aminoglycoside Antibiotics)

Selection of Antimicrobial Agent & effective chemotherapy

July 17th, 2011

Selection of Antimicrobial Agent & effective chemotherapy

In addition to knowledge about the properties of the available antimicrobial agents important considerations in the choice of effective chemotherapy are:

I. The nature and site of the infection.

2.  Adverse effects.

3.  Factors determining the resistance of organisms to antimicrobial agents.

4.  Cost.

1. Selection of Antimicrobial Agent in Relationship to the Nature and Site of the Infection

Antimicrobial Agent & effective chemotherapy

In instances where the nature of the infection can be reliably predicted from the clinical features of the illness, treatment can proceed without isolation of the causative organism. For example, acute follicular tonsillitis and lobar pneumonia are sufficiently characteristic on clinical examination to allow the causative organism and its antibiotic sensitivity to be assumed with a high degree of probability and the appropriate antibiotic (penicillin) given. In acute exacerbations of chronic bronchitis the causative organisms are almost always pneumococci and Haemophilus influenzae and the use of ampicillin or co-trimoxazole is indicated without specific laboratory diagnosis. Read the rest of this entry »

SEVERE MALARIA

Posts Tagged ‘Parasite’

SEVERE MALARIA

Severe Malaria is defined as severe manifestation of malaria that may contribute to major organ dysfunction or failure (e.g. coma, renal failure or pulmonary edema) or even death if treatment is not proper or urgent. Severe malaria is mainly caused by Plasmodium falciparum but not all cases of P. falciparum are severe. The treatment of this condition requires hospitalization and specialist care.

In case of P. falciparum infection the symptoms usually begin 10 to 35 days after mosquito injects theparasite. Initial “prodromal” symptoms are followed by the paroxysms. Unlike other forms of malariathe paroxysms are not regular and patients often do have fever between the paroxysms. Theparasite load is high in falciparum infection because this type can infect red blood cells of any age. This is one of the reasons for severity of malaria caused by P. falciparum. The most important and potentially fatal complication is cerebral malaria that occurs commonly in infants, pregnant women and non-immune travelers to high-risk areas. Untreated P. falciparum malaria is fatal in about 20% of people and prompt and adequate treatment is required to prevent fatalities.

Variation in Micro-organisms

Variation in Micro-organisms

In common with other living creatures micro-organisms adapt to their environment by changes in their genetic structure which result in variation of characters in a proportion of their progeny. These changes become apparent in a relatively short time because of the high rate of reproduction of micro-organisms so that differences affecting a large proportion of a population producing an infection may be noticeable during the period of the disease. When the characters affected by these genetic changes are related to pathogenicity, virulence and resistance to antimicrobial agents, they are of particular importance in medicine and in the management of individual patients.

SPREAD OF INFECTION

SPREAD OF INFECTION

The Routes of Transmission of Micro-organisms

(1)   Autogenous Sources. The pathogenic organism may invade directly from the site at which it is growing – e.g. a commensal Staph. Pyogenes may cause a boil or the micro-organisms may spread locally to different sites on the body surfaces. Thus Strept. Pyogenes from the nasopharynx may cause erysipelas of the face, or Esch. Coli from the large bowel may pass from the anus to the urethra and invade the urinary tract. Alternatively the transmission may be by the blood stream, as when a tooth is extracted and Strept. Viridians from the mouth enters the blood and colonizes abnormal heart valves and produces bacterial endocarditis.

DEFENSE OF THE HUMAN HOST

DEFENSE OF THE HUMAN HOST

Susceptibility of host to infection. Many animal and human races differ in their susceptibility toinfection. For example Negroes whose red cells contain hemoglobin S are relatively immune to malaria. Man and the guinea-pig may be infected by human or bovine strains of the tubercle bacillus, but are unaffected by the avian strain. Rabbits are very susceptible to experimental infection with the bovine strain, rabbits are very susceptible to experimental infection with the bovine strain, though they seldom if ever contract tuberculosis naturally. Birds on the other hand are susceptible only to the avian variety. When measles was first introduced by traders into the Fiji Islands there was a very high mortality rate at all ages.

Posts Tagged ‘micro organisms’

Identification of the causal organism

This may be made by methods of direct diagnosis including demonstration of the organism microscopically in preparations of tissue, exudate or excreta, isolation of the organism in laboratory culture or, more rarely, its growth in laboratory animals. In cases where these methods are inapplicable or unavailing, methods of indirect diagnosis must be used to demonstrate the presence of specific antibody in the patient’s serum. The significance of the isolation of certain micro-organisms may require further support by the demonstration of homologous antibody, e.g. the mere isolation of an enterovirus from the faeces may be equivocal without an accompanying significant rise in corresponding antibody titre