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  • Tonsilitis

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    Tonsil: a small, rounded mass of tissue, especially of lymphoid tissue; generally used alone to designate the palatine tonsil.

    Tonsillitis:  inflammation of the tonsils . It can be acute or chronic.  The uncomplicated acute form usually last 4 to 6 days and commonly affects children between the ages of  5 through 10, but can affect any age.

    Tonsils tend to hypertrophy during childhood and atrophy after puberty.  (hypertrophy:  enlargement or overgrowth of an organ) (atrophy:  a wasting away)

    Tonsillitis most common cause is beta hemolytic streptococci (a bacteria). The condition can also result from other types of bacteria and viruses.

    Symptoms:

    • Acute tonsillitis:  discomfort usually subsides after 72 hours Mild to severe sore throat (for children who are too young to describe pain, he/she  may have loss of appetite and or stop eating)
    • Dysphagia (difficulty swallowing)
    • Fever
    • Swelling and tenderness of lymph glands in the submandibular area
    • Muscle and joint pain
    • Chills
    • Malaise
    • Headache
    • May complain of ear pain An urge to swallow constantly Tight feeling towards the back of throat

    For chronic tonsillitis: complains of frequent sore throat, purulent (contain pus) drainage in tonsillar crypts, and frequent episodes of acute tonsillitis

    Your doctor may take a culture to determine the infecting organism. Lab  test may show  an elevated white blood cell count

    Treatment: 

    • Rest
    • Adequate fluid intake
    • Acetaminophen or Aspirin, as order

    Antibiotics may be prescribed by your doctor To prevent complications, antibiotic therapy should continue for 10 days or when medication is complete unless specified by your doctor)

    Chronic tonsillitis may require a tonsillectomy (removal of the tonsils), but only after the patient has been free of tonsillar or respiratory tract infections for 3 to 4 weeks. Below is an enlarged tonsil with the presence of white pus from a probable infection. The most common bacterial infection is a streptococcal or (strep throat) Signs of a strep throat include: A bright red or strawberry appearance of the tongue, The back of the throat appears bright red, Painful swallowing, Fever, can reach as high as 104 or higher (“scarlet fever”) If strep a throat is suspected, patients need to be on antibiotic therapy as soon as possible.

  • Trichomoniasis

    Trichomoniasis: This protozoal infection
    of the lower genitourinary tract affects about 15% of sexually active females
    and 10% of sexually active males. The infecting agent is Thrichomonas
    vaginalis. Most commonly spread by sexual contact, trichomoniasis may also be spread by contaminated douche equipment
    or moist washcloths, or if the mother is infected, via vaginal delivery. In females, the condition may be acute or chronic.
    Recurrence of trichomoniasis is minimized when sexual partners are treated concurrently.

    Risk factors for infection include bacterial overgrowth, pregnancy,
    exudative vaginal or cervical lesions, frequent douching and use of oral contraceptives.

    Symptoms:

    Usually patients experience no symptoms.

    Acute infection may produce variable signs and symptoms; Women
    may experience a vaginal discharge (gray or greenish yellow and
    possibly profuse, frothy, and bad smell to it (malodorous), patient may
    experience “strawberry spots” on the cervix, severe itching, redness,
    swelling, tenderness, dyspareunia
    (difficult or painful intercourse), dysuria (painful urination) and
    urinary frequency. Females may also experience spotting after
    intercourse
    (postcoital), menorrhagia (excessive menstruation), or dysmenorrhea
    (Painful menstruation).

    Men may develop transient mild to severe urethritis, dysuria, or urinary
    frequency.

    Treatment:

    Metronidazole by mouth is given to both sexual partners, prognosis is
    excellent.

    Females, a mild douche with a vinegar and water solution may help acidify
    vaginal pH, consult your doctor.

    * do not douche before being examined for trichomoniasis, and
    or pelvic exams.

    For pregnant patient, your doctor may prescribe clotrimazole vaginal
    tablets/cream at bedtime for 7 days. * As with all medication use as prescribe by your doctor.

    After treatment, both sexual partners need to have a follow up examination
    by your doctor to check for residual signs of infection.

    To prevent reinfection during treatment, abstain from intercourse, or
    use condoms.

    * Important – When using metronidazole treatment, abstain
    from alcoholic beverages, because alcohol consumption may provoke a disulfiram – type reaction (confusion, headache, cramps,
    vomiting, and convulsions). Using metronidazole may turn urine dark brown.

  • Tuberculosis

    Tuberculosis is an acute or chronic infection, that
    can spread through the lymph nodes and bloodstream, circulatory system,
    and or to any organ in your body, it is usually found in the lungs. This
    disease is spread by inhalation of droplet nuclei when infected persons
    cough or sneeze.  Sites of extra pulmonary tuberculosis include the
    pleura, meninges, joints, lymph nodes, peritoneum, genitourinary tract,
    and bowel.

    TB major cause is Mycobacterium tuberculosis, other strains of
    mycrobacteria may be involved.

    Risk factors: primary infection include poverty and crowded,
    poorly ventilated living conditions.

    For reinfection include gastrectomy, uncontrolled diabetes mellitus,
    opportunistic infections, Hodgkin’s disease, leukemia, corticosteroid therapy,
    and immunosuppressant therapy.

    Symptoms:

    In primary infection, the disease is usually asymptomatic.

    May experience fatigue, weakness, anorexia, loss of weight

    Night sweats

    Low grade fever

    Persistent cough

    Cough, with occasional blood in the sputum

    May experience, pain the the chest, back and pain in the kidneys.

    * A mantoux skin test is done to detect TB, if it shows positive,
    your doctor may order a chest X-ray to confirm and to see if the disease
    has spread.

    Treatment:

    If infected, your doctor may prescribe an antibiotic medication for
    preventive measure; probably Isoniazid also called INH therapy or Rifampin
    (with ethambutol added in some cases), for at least 9 months.  After
    2 to 4 weeks, the disease is usually no longer infectious.

    If you have the active disease, your doctor may prescribe second line
    medication such as capreomycin, streptomycin, cycloserine, para amino salicylic
    acid, and or pyrazinamide.

    May require hospitalization and isolation. With antibiotic treatment

    Call your doctor if you experience any of the above symptoms, and or
    if you feel that you have been exposed.

  • Ulcerative Colitis

    This inflammatory, often chronic disease affects the
    mucosa and submucosa of the colon.  It usually begins in the rectum
    and sigmoid colon and often extends upward into the entire colon (colon: 
    which is the name for the longer part of the large intestine, extends up
    from the cecum along the right side and then bends to extend across the
    abdomen to the left side).  It rarely affects the small intestine,
    except for the terminal ileum (ileum join the large intestine through another
    muscular valve called the ileocecal sphincter).

    Severity ranges from a mild, localized disorder to a fulminate
    disease that may cause a perforated colon, progressing to potentially fatal
    peritonitis and toxemia. This disorder occurs primarily in young
    adults, especially women. It’s also more prevalent among Jews and
    in higher socioeconomic groups.

    Risk factors include a family history, bacterial infection, allergic
    reaction to food, milk, or other substances that release inflammatory histamine
    in the bowel, over production of enzymes that break down the mucous membranes,
    and emotional stress. Auto immune disorders, such as rheumatoid arthritis,
    hemolytic anemia, may heighten the risk.

    Symptoms:

    Recurrent bloody diarrhea and asymptomatic  (showing or
    causing no symptoms) remissions are characteristics of ulcerative colitis.

    May contain pus and mucus in the stools.

    Spastic rectum and anus

    Abdominal pain

    Irritability

    Weight loss

    Anorexia

    Weakness

    Nausea and Vomiting

    Your doctor may order:

    A barium enema

    Biopsy

    Sigmoidoscopy

    Colonoscopy

    Stool specimen may be cultured and analyzed 

    Lab works

    Treatments:

    Goal; to control inflammation, replace nutritional losses and
    blood volume, and prevent complications.

    Drug therapy to control inflammation

    Supportive treatment: bed rest, IV fluid replacement and
    clear liquid diet.

    Surgery is the treatment of last resort if the patient has toxicmegacolon,
    fails to respond to drugs and supportive measures, or finds symptoms unbearable.

    * Call your doctor if you are experiencing the above symptoms
    promptly.

  • Urinary Tract Infection

    The urinary system is also called the excretory
    system, and its job is store move certain waste products from the blood
    and eliminate them from the body.

    Cystitis and urethritis constitute the two types of urinary
    tract infection ( UTI ).

    Urethritis: inflammation of the urethra.

    Cystitis: inflammation of the bladder.

    Cystitis usually results from an ascending infection. Cystitis
    and urethritis (UTI) commonly respond readily to treatment, but recurrence
    and resistant bacterial flare – up during during course of therapy is possible.

    Women are more prone to have UTI, more so than men. UTI is also
    a prevalent bacterial disease in children, with girls also most commonly
    affected. Doctors suspect that because women have a shorter urethra ( the
    tube that carries urine out of the bladder ), it is a short passageway,
    only about an inch and a half long. It makes it easier for bacteria to
    migrate into the bladder. Also, the opening to a woman’s urethra lies close
    to the vagina and the anus, giving bacteria from those areas access to
    the urinary tract.

    In men and children, UTI is commonly related to anatomic or physiologic
    abnormalities. Some other causes of UTI include gram-negative enteric
    bacteria (typically Escherichia coli, Klebsiella, Proteus, Enterobacter,
    Serratia, or Pseudomonas)

    Symptoms:

    Urinary urgency and frequency

    Dysuria ( pain when urinating )

    Bladder cramps or spasms

    Itching

    Feeling of warmth during urination

    Nocturia (excessive urination at night )

    Possibly hematuria ( process of blood in the urine )

    Possibly fever

    Possibly urethral discharge in males.

    Other symptoms includes:

    Low back pain, malaise, nausea, vomiting, abdominal pain or tenderness
    over the bladder, chills, and flank pain.

    Treatment:

    Your doctor may prescribe a 7 to 10 day course of an appropriate antibiotic
    to treat UTI.  IMPORTANT- complete prescribed course of therapy unless
    specified by your doctor.

    Single-dose antibiotic therapy with amoxicilliln or cortrimoxazole may
    be effective in women with acute non-complicated UTI.

    Recurrent infections caused by infected renal calculi, chronic prostatitis,
    or a structural abnormality may necessitate surgery.  In patients
    without these predisposing conditions, long-term, low-dose antibiotic therapy
    is the treatment of choice.

    * Take all of your prescribed antibiotic even if and when you
    feel better.

    * Drink plenty of water, at least 8- 8 oz of water per day.

    * With long term prophylaxis, adhering strictly to the ordered
    dosage.

    * Fruit juices, especially cranberry juice helps to fight UTI

    * Vitamin C may help acidify the urine and enhance the action
    of the medication.

    * If therapy includes phenazopyridin, patient urine may be red
    orange.

    *Women should urinate immediately after intercourse.

    * Females: wipe after urinating from front to back (avoid wiping
    from the anus upwards to the vagina) and after defecation (bowel movement)
    wash hands thoroughly with soap and water.

    * Take frequent stops during long car trips to empty your bladder

    * To prevent recurrent infections in men, Prompt treatment
    of predisposing conditions, such as chronic prostatitis.

    See your doctor if you are experiencing any of the above symptoms.

  • Uterine Problems

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    Uterus:  the organ to which the fallopian
    tubes lead is the uterus, and it is within this structure that the fetus
    grows until it is ready to be born.

    The uterus is a pear-shaped muscle about 3 inches long 2 inches
    wide, and 1 inch deep.  The upper portion rests on the upper surface
    of the urinary bladder; the lower portion is embedded in the pelvic floor
    between the bleared and the rectum.  The upper portion is the larger
    and is called, the body, or corpus; the lower, smaller part
    is the cervix, or neck.  The small rounded part above
    the level of the tubal entrances is known as the fundus. 
    The cavity inside the uterus is shaped somewhat like a tiny capital T,
    but is capable of changing shape and dilating as the embryo ( later called
    the fetus ) develops.  The cervix lead to the vagina,
    the lower part of the birth canal, which opens to the outside of the body.

    The interior layer of the uterus is a specialized epithelium
    known as endometrium, and it is this layer which is involved
    in menstruation.

    Reverse and Eliminate Ovarian Cysts

    Dysfunctional uterine bleeding: an abnormal
    endometrial bleeding.  Heavy menstruation or bleeding longer than
    8 days (menorrhagia), bleeding between periods (metrorrhagia),
    or a cycle that is less than 18 days ( chronic polymenorrhea ),
    may cause iron deficiency anemia.

    Uterine leiomyomas:  also known as myomas,fibromyomas,
    and fibroids.  These neoplasm’s are the most common
    benign tumors in women.  They usually occur in the uterine corpus,
    although they may appear on ht cervix or on the round or broad ligament. 
    Uterine leioomyomas are usually multiple and occur in approximately 20%
    of all women over age 35.  It affect blacks three times more often
    than whites.  They become malignant (leiomyosarcoma ) in only .1%
    of patients.

    Fibroids may cause enlargement and distortion of the uterus and patients
    may have difficulty with conception. In some patients sometimes a fibroid
    attached to the uterine wall may become twisted or may outgrow its blood
    supply, , causing it to be starved for blood and oxygen, when this happens,
    you may suddenly feel a sharp pain in your abdomen.  Call your doctor
    promptly.

    Fibroids may cause bladder or bowel pressure or make intercourse painful.
    If you experience excessive heavy menstrual cycle , patient could develop
    anemia.

    The cause of uterine leiomyomas is unknown, but excessive levels
    of estrogen and human growth hormone (HGH) may influence tumor formation
    by stimulating susceptible fibromuscular elements.  large doses of
    estrogen and the later stages of pregnancy increase both tumor size and
    HGH levels.  Uterine leiomyomas usually shrink or disappear after
    menopause, when estrogen production decreases.

    Prolapsed Uterus: A prolapsed uterus occurs when
    the uterus descends from its normal position in the lower abdomen.

    Severe cases: the uterus is visible through the vulva ( the external 
    genital organs of the female ).  Prolapsed uterus is most common in
    middle aged women who have had children weighing more than eight pounds
    at birth and or multiple births, but it may also occur in childless women.

    Symptoms:

    Pain and or heaviness in the abdomen

    Hypermenorrhea (excessive menstrual bleeding )

    Dysmenorrhea (painful menstrual bleeding)

    Constipation

    Urinary frequency or urgency

    Irregular uterine enlargement

    Treatment:

    Treatment for fibroids varies, see your doctor for course of
    treatment.

    Hysterectomy – optional, and or depending on condition and doctor
    course of treatment.

    Discontinuing of hormone replacement therapy – Depending on your
    doctors course of treatment

    Myomectomy (removal of fibroids) Depending on your doctors
    course of treatment

    Your doctor may prescribed birth control pills for patients with dysfunctional
    uterine bleeding, or Progestins or gonadotropin releasing hormones (GnRH) may also be prescribed
    to control bleeding (it may take more than 30 days to show any effect and
    have many side effects)

    *If you decide you do not want surgery, your doctor may
    insert into the vagina a plastic device known as a pessary, which sits
    in the vagina  (like a diaphram) to hold the uterus in place. This
    must be replaced every three to six months and is thus not a long term
    solution.  – for Prolapsed uterus.

    To strengthen the uterine-support ligaments and to control urination
    : do Kegel exercises – a pelvic floor exercises to help hold your prolapsed
    uterus in place.  * Start by stopping your urination flow midstream,
    hold it for approx. 5 seconds then release the flow.  Once you are
    familiar with the targeted muscles, practice tightening and relaxing them.
    Start with 4 to 5 sets of the exercises are recommended, up to 10 times
    a day.

    If you have chronic pain low in the abdomen, your menstrual
    cycles are frequent and or excessively heavy, call your doctor promptly.

  • Zinc Deficiency

    Zinc: Is an essential
    trace element present in the bones, teeth, hair, skin, testes, liver, and
    muscles. It also forms a vital component of many enzymes.
    It promotes synthesis of deoxyribonucleic acid ( DNA ), ribonucleic acid (RNA ), protein and maintains normal blood
    concentrations of vitamin A by mobilizing it from the liver. This disorder
    is most common in the underdeveloped countries, especially in the Middle
    East.  Children are most susceptible to this deficiency during periods
    of rapid growth, but with proper treatment, patients has a good outcome.

    Zinc deficiency usually results from inadequate intake of foods high
    in zinc, such as seafood, oatmeal, bran, meat, eggs, and nuts, or from
    impaired absorption caused by short bowel syndrome, Crohn’s disease, or
    pancreatic insufficiency.  It may also be due to excessive intake
    of foods containing iron, calcium, vitamin D, and the fiber and phytates
    in cereals, that bind zinc to form insoluble chelates that prevent its
    absorption.  It occasionally can results from blood loss caused by
    parasitism.  Alcohol, cirrhosis, dialysis, burns, draining wounds,
    and corticosteroids increase renal excretion of zinc.

    Symptoms:

    Enlargement of the liver and spleen (hepatosplenomegaly)

    Sparse hair growth

    Soft and misshapen nails

    Anorexia

    Hyposmia (decreased odor acuity)

    Dysosmia (unpleasant odor in nasopharynx)

    Severe iron deficiency anemia

    Bone deformities

    Chronic form:  hypogonadism (decrease functional activity of
    the gonads, with retardation of growth and sexual development)

    dwarfism and hyper pigmentation.

    Protein malnutrition and poor wound healing may occur

    Treatment:

    Correcting the underlying cause of the deficiency
    Zinc supplements
    A balanced diet
    Correct use of calcium and iron supplements.

    Diet consists of seafood, oatmeal, bran, meat, eggs, nuts and dry yeast.

    When taking zinc supplements, take with meals to prevent gastric distress and vomiting.

    Dairy products may hinder zinc absorption

    Avoid excess intake of zinc, which can cause GI discomfort.

    * With any and all medications, use as prescribed by your doctor.

  • Yeast Infections

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    Yeast, or fungal, infection: also called Candidiasis

    YEAST: A General term including single-celled, usually rounded
    fungi that produce by budding, some of which transform to a mycelial stage
    under certain environmental conditions, while others remain single-celled.

    Infection: Invasion and multiplication of microorganisms in body
    tissues.

    Candida: A genus of yeast like fungi that are commonly part of the
    normal flora of the mouth, skin, intestinal tract, and vagina, but can
    causes a variety of infections.

    Candidiasis:  infection by fungi of the genus (a particular
    group or category into which related organisms are classified (taxon).

    Yeast infections takes many forms. yeast infection often develop
    where a moist environment encourages fungal growth. It is seen especially
    on the genitals, webs of fingers and toes, folds of skin and nails.

    Oral thrush is usually painless, often recurrent infection of the
    mouth and throat. It is common in babies, young children and the elderly,
    but also affects all ages.

    Moniliasis (candidiasis) is a painful vaginal yeast infection experienced
    by many women, most commonly during pregnancy or when patient is being
    treated with antibiotics.

    Balanitis (inflammation of the glans penis) is less common but equally
    irritating infection of the penis.

    Systemic yeast infections can occur in cases of diabetes, AIDS, and
    other conditions or drug treatments that suppress the immune system.

    Symptoms:

    In women, vaginal itching and irritation, unusually thick,
    white discharge; redness and swelling of the vulva (the external organs
    of the female) including the mons pubis, labia majora and minora, clitoris,
    and vestibule of the vagina) and may experience pain during intercourse.

    In men ,red patches and blisters at the end of the penis and around
    foreskin, may experience itching and pain.

    Oral thrush,  experience painless white patches in mouth or
    throat that may or may not come off when eating or brushing teeth; most
    common in infants, AIDS patients, and the elderly.

    Esophageal thrush, experience; white patches in the mouth and throat,
    sometimes associated with painful swallowing.

    Intertrigo (an erythematosus skin eruption occurring on apposed skin
    surfaces), experience; itchy or burning shiny, pink rash with a scaly or
    blistered edge in the folds of the skin. may have skin peeling on the hands,
    between the fingers, and swollen nail folds above the cuticle; possible
    painful, red and may contain pus.

    Treatment:

    Treatment will depend on your symptoms and specific condition, but
    will focus on counteracting the growth of the yeast organism that causes
    the infection.

    *Oral thrush: Antifungal medication such as clotrimazole
    or ketoconazole. For babies or young children with oral thrush are normally
    given nystatin oral suspension (with dropper).

    *Intertrigo -(nail. and skin): Topical applications of clotrimazole.

    *Vaginal yeast infection: Your doctor may prescribe a cream with
    terconazole or an oral antifungal medication containing fluconazole. And
    if your doctor determines that you have a systemic yeast infection, you
    may get IV doses of amphotericin or flucytosine. It is important that you
    see your Doctor, especially if you are experiencing this for the first
    time.

    Miconazole or Clotrimazole topical cream. There are over the counter
    topical cream containing miconazole or clortimazole in the market today.
    (For first time infection, see your doctor to be sure that you do have
    a yeast infection) with all medication, use as prescribed by your doctor.

  • Xeroderma Pigmentosum

    Xeroderma Pigmentosum or XP is a very rare, heritable
    disorder.  A genetic defect in ultraviolet radiation induced DNA repair
    mechanisms.  Distinguishing features; increase sensitivity to UV radiation,
    especially sun light.

    Early intervention and diagnosis can delay the onset of it’s many complications.
    and or can lead to death.  It appears typically by 1 – 2 years of
    age, with the detection of severe sunburn with just the very minimal exposure
    to sunlight, and freckles – like spots on exposed areas, later symptoms
    includes; premature aging, cancer of the skin, eye problems and neurologic
    abnormalities can develop.

    Xeroderma pigmentosum is categorized in different groups according
    to the capacity of the body to repair DNA.

    Symptoms:

    Sun – burns easily, developing blisters with just minimal sun exposure

    Deafness

    Dwarfism ( hypergonadism )

    Developmental disabilities

    Skin Cancer

    Mental retardation

    Eye Cancer

    Failure of muscular coordination

    Can be life threatening

    Treatment:

    Early detection and interventions

    Management of this disorder

    Gene therapy for DNA repair

    Protein Therapy

    Seek medical treatment promptly if you suspect your child to have
    sensitivity to any UV source.

  • Xanthoma

    Xanthoma:  a yellow papule, nodules, or plaque
    in the skin due to lipid deposits; microscopically the lesions show light
    cells with foamy protoplasm (foam cells).

    It can appear anywhere in the skin, but more common on the elbows,
    knees, hands and feet.  It can appear in the joints and tendons, usually
    painless.

    Xanthomatosis: an accumulation of excess lipids in the body, and or
    fatty degeneration of the cornea due to disorder of lipid metabolism, marked
    by xanthomas.

    Xanthoma; fatty deposit under the skin, usually benign and painless.
    It is a common skin disorder mark by yellowish red to brown in color. 
    Usually caused by increase blood lipids ( fat levels ), increase blood
    cholesterol level, and triglycerides level.

    Xanthomas is associated with diabetes.

    Symptoms:

    Skin lesion

    Raised, flat bumps under the skin

    Color may be yellowish, yellowish red to brown

    Benign and painless

    May cause disfigurement

    Treatment:

    To control this condition, by controlling the blood lipids, cholesterol,
    and triglycerides levels.

    You and your doctor may decide to surgically remove it.

    * NOTE: nodules may return