With the change of season, we all have to be geared up for the increase in the number of mosquitoes in and around our homes, and among these is one such mosquito, which can be fatal for your life. The bite of the  Aedes aegypti  mosquito causes Dengue. This mosquito survives and breeds in tropical and sub-tropical areas. It is a waterborne disease and causes extreme pain, discomfort and in some cases even death. Each year 390 million people are inflicted with dengue out of which 96 million develop serious illnesses and are required to be hospitalized.

Causes:
1. As mentioned above it is caused by the bite of the  Aedes aegypti  mosquito.
2. When a mosquito bites a person who already has dengue, it becomes infected and it can be transmitted to any healthy person this mosquito bites next.
3. If you already have dengue and are infected again then you have a higher chance of developing dengue hemorrhagic fever or a dengue shock which can even cause death.
4. Living near a stagnant water body, or accumulating water in open containers, staying in the vicinity of clogged drains and open windows can also expose you to the threat of Dengue.

Symptoms:
The symptoms can last to about 10 days after one gets infected. The symptoms are as follows:
1. Excruciating pain behind the eyes
2. Severe headache
3. Sudden high fever.
4. Vomiting
5. Fatigue
6. Skin rash which generally appears two to five days after you get bitten.
7. Nose bleeding, easy bruising and bleeding gums.
8. Severe muscle and joint pain.

These symptoms can be mistaken for high fever or viral infection, so it is important to get tested as soon as you start experiencing these symptoms. If dengue is not treated in time, it can give rise to dengue hemorrhagic fever. In this case, you can suffer from high fever, nose bleeding (damage of blood vessels), failure of the circulatory system and enlargement of liver.

You can also prevent dengue by avoiding storing water in containers, keeping your surroundings clean, wearing full body clothing, using mosquito repellants, sleeping under a mosquito net and setting mosquito traps. Dengue is very devastating and can cause death in worse cases as in dengue shock or dengue hemorrhagic fever. Dengue is now an epidemic in many countries. People affected with dengue need to drink a lot of fluids and take plenty of rest. They can also reduce the fever by having a paracetamol.

Dengue - Signs You Must Be Careful About!

Pain management is an issue that stares back at mankind, irrespective of the underlying health condition. Whether it is a headache or a back pain, burn or fracture, heart attack or cancer, pain is always a symptom. In some cases like migraines, cancer, etc., the pain is chronic and the patient needs to be constantly on the vigil to know when an attack will ensue. This has also put high pressure on the medical fraternity to identify ways that can provide relief to these people. Various methods have been identified, and one of them is the electrotherapy.

What is done?
A few electrical impulses are directed at the area of the pain using a hand-held device. This is similar to providing electric shocks of mild intensity to the affected area (forehead, low back, neck, etc.). What this does is stimulate the nerve endings, improves circulation and muscle strength and promotes bone growth and tissue repair. The end result of all this is overall improved functioning and pain relief. Depending on the actual condition, the sessions will have to be repeated. In some patients, the electrotherapy is used in conjunction with other therapy so that they can go about their routine exercise and pain relief.
The sessions may also have to be repeated as most often these are used in individuals with chronic pain. They are also helpful in providing relief during the acute attacks.

How does it work?
The most common form of electrotherapy is known as TENS, which stands for transcutaneous electrical nerve stimulation. The area to be treated is cleansed with spirit and then small sticky pads are applied through which the electricity is passed. A hand-held device is used, through which electrical impulses are passed to the skin, which stimulates the nerve cells to provide relief from pain. It causes a vibrating and tingling sensation in the treated area. It is believed that it blocks the nerve impulses and therefore provides pain relief. Another theory states that they promote the release of endorphins which are natural painkillers; it is also very effective in case of migraine and sciatica and neck pain where the chronic pain is coupled with acute spurts.

With narcotic painkillers having various side effects, techniques like electrotherapy are gaining popularity. A small catch also is that it does not work for everybody and in most people with back pain, fibromyalgia, and migraines, requires repeat sessions for relief. The cost of each session also needs to be considered against the extent of relief achieved. However, for those whom it works, it is a very good technique for chronic pain control.

Electrotherapy - How It Can Help In Managing Pain?

What is a foreign body (FB)?
Foreign body or FB is an object or piece of extraneous matter that has entered the body by accident or design. It is common to see certain items getting stuck in the ear, nose or throat especially, in young children. While most of the time they do not raise an alarm, however, sometimes they can lead to severe consequences like rupture of the eardrum or even choking.

How do FBs affect ear, nose and throat?

Children over 9 months develop an ability to pick up objects. As they explore the environment around them, they tend to put items such as peas, beans, marbles, beads, cotton, paper, etc, in their mouth, nose or ears. Similar trend may be seen in adults with mental disorders.
Trauma/ fall/accident can force FBs like rock, pebbles into the ear, nose or throat.
Adults while riding a bike or sleeping on the ground (campsites) can have insects: flies, ants, roaches fly into the nose or ear.
Choking occurs when FBs block the airway, common reasons are: not chewing the food properly, diseases like Parkinsonism, drinking alcohol or certain drugs that slowdowns the process of swallowing.
Managing FB in the ear, nose and throat

Foreign bodies in the ear
Symptoms: Pain in the ear, discharge or bleeding from the ear, feeling of fullness or pressure in the ear and dizziness and nausea in extreme cases.

Management: 

Make sure the patient is sitting in an upright position, pull the pinna or outer semicircle of the ear towards the back. This can help you see the object clearly and also loosen it to wiggle out. If you can see the object clearly, use a tweezer to grasp the object and gently remove.
In case a live insect gets trapped inside the ear lie down and place few drops of warm vegetable or baby oil. Use oil only if symptoms of eardrum perforation like pain, bleeding/discharge from the ear is absent.
Tilting the head to the affected side can facilitate gravity to dislodge the object.
Foreign bodies in the nose:
Symptoms: Pain and difficulty in breathing from that side of the nose.
Management: Keep the uninvolved nostril closed by pressing a finger against the side of the nose and gently ask the person to blow from the affected nostril.

Foreign bodies in the throat:
Symptoms: Choking, inability to breathe and speak 
Management: Perform Heimlich maneuver: abdominal thrusts, if trained otherwise, it is advised to call for medical help immediately.

How can you prevent foreign bodies from entering your ear, nose, throat?

Discourage talking, playing, laughing when food is in the mouth.
Do not give whole grapes, popcorn, nuts to children below 3 years.
Keep small objects out of reach of small children.
Teach children to avoid placing objects into their nose, ears.

Presence Of Foreign Bodies In Ear/Nose/Throat - How It Can Be Managed?

Cyclic vomiting syndrome (cvs) is characterized by periodic bouts of nausea and vomiting that happens at cyclical intervals. It affects all ages, but is more common in children. The condition is quite stereotypical in that there are paroxysms or bouts of vomiting that is recurrent and follows days of normal health.

Causes: there is no definite reason identified, but it is said to have a strong hereditary correlation. Studies have shown mitochondrial heteroplasmic (abnormal growth of mitochondria, which is a cellular component) to be one of the factors that can lead to cvs. The genetic correlation, however, is very difficult to establish, specifically because vomiting and nausea are common symptoms that occur with most conditions in children. And cvs is most commonly noted with conditions like infections and emotional excitement. Infection could be either tooth decay or sinusitis or anything else. Lack of sleep, anxiety, holidays, allergies, overeating, certain foods, menstruation - a host of factors have been shown to induce cvs. There is also a strong association with migraine and conditions that lead to excessive production of stress hormones.

Symptoms: the syndrome (a group of symptoms) usually has 4 phases:

1. Symptom-free interval phase: the child is completely normal in this phase, which happens in between bouts.

2. Prodromal phase: prodrome is an indication that a disease or a condition is about to happen. In cvs, this is usually nausea and abdominal pain that can last from a few minutes to a few hours. Treatment in this phase can curb the disease. However, there could be some children in whom this may not manifest and the child may directly start with vomiting.

3. Vomiting phase: repeated bouts of paroxysmal vomiting happen associated with nausea, exertion, fatigue, and drowsiness.

4. Recovery phase: as the nausea and vomiting begin to subside, which may take a couple of days, the child returns back to normal slowly. However, the lethargy and energy levels will take a couple of days to return to normal.

Treatment: treatment again depends on the severity and the phase at which it is being recognized. If a child has repetitive bouts, then the parent and the doctor would have identified a pattern to it.

1. If the causative agent has been identified, for instance, infection or migraine, then managing that takes care of the cvs also.

2. If identified during the prodromal phase, again it can be managed with suitable anti-emetic medications.

3. If identified after full onset, rest and sleep and medications to control nausea and vomiting are required. Adequate hydration with electrolyte replenishment and sedatives can provide additional support.
However, in most cases of childhood csv, the pattern will be identified and that helps in better management, both the child/parent and the podiatrist.

Cyclic Vomiting Syndrome in Children - Causes, Symptoms, Treatment

Many children are affected by constipation; for them, it usually implies pain while passing stool as the stools tend to be hard. In some cases, parents often tend to confuse soiling as diarrhea when it may actually indicate symptoms of impacted constipation (obstruction of faeces). In order to prevent constipation from turning into a chronic problem, make sure your child receives proper treatment at the earliest.

Symptoms of constipation
Constipation in children can be characterized by its symptoms which are:
1. Your child will experience difficulty in passing stools
2. He/she may also experience pain during the process; trace amounts of blood may be present on the nappy.
3. The stool tends to be large in size and hard by nature
4. The child may not have normal bowel habits; he may pass stools less than the normal number of times.
5. Loss of appetite
6. He/she may experience intense pain in the stomach
7. This condition may cause sudden changes in behavior; your child may become irritated or unhappy very easily.
8. He/ she may experience nausea
9. The child may also often soil his/her clothes by passing feces at irregular intervals

Causes of constipation in children
Constipation in children may be caused due to a number of factors, which are:
1. Withholding of stool: In some cases, your child may try to forcefully hold back bowels every time he/she may want to go to the toilet. This may happen due to reasons such as lack of toilet training or not wanting to use toilets at certain places.

2. Diet: A diet devoid of fiber may be the cause behind your child's constipation. Also, not drinking enough water throughout the day may cause the stools to harden, thus causing difficulty while passing them. The fiber content in food adds roughage to the diet and thus, helps in facilitating smooth bowel movements.

3. Psychological problems: Constipation may also be caused due to certain emotional problems and drawbacks, such as certain fears or phobias. An example would be when the child feels the need to go to the toilet at night, but withholds it if he/she has a fear of ghosts. A change in the surroundings such as moving to a new place may also cause bowel problems in your child.

Causes of Constipation in Children

The term cirrhosis refers to liver scarring due to various diseases and conditions such as chronic alcoholism and hepatitis. Each time the liver gets injured, it tries to repair itself, resulting in the formation of the scar tissue. With the progression of cirrhosis, a number of tissues generate making the task of liver difficult. Since the liver is an important organ of the body due to its functionalities such as detoxification and nutrient generation, reduced function of liver poses a serious threat to the body.

Symptoms of liver cirrhosis:
Unfortunately, cirrhosis doesn t portray any conspicuous symptoms that can be easily identified until the scarring has reached a level of threat. Some of the common signs and symptoms of this disease include fatigue, nausea, itchy skin, drowsiness, enlarged breasts, testicular atrophy, fluid in the abdomen, bleeding from the mouth, leg swelling, redness in palms etc.

Causes of liver cirrhosis:
There could be an array of reasons for the occurrence of liver cirrhosis. The major causes include an accumulation of fat in the liver, chronic alcoholism and chronic hepatitis. Some of the other reasons include cystic fibrosis, bile duct deformation, Wilson s disease, hemochromatosis, schistosomiasis, continuous consumption of medicines such as methotrexate, a disease involving glycogen storage and Aalagille syndrome.

Complications involved in liver Cirrhosis:

High blood pressure: Cirrhosis results in slow blood movement through the passage of the liver resulting in an increased pressure on the vein that is responsible for carrying blood from the intestine to the liver. This increases the blood pressure in the body.
Swelling of abdomen and legs: Portal hypertension can result in accumulation of fluid in the leg and the abdomen due to the liver s inability to producing an important protein known as the albumin.
Spleen enlargement: Portal hypertension is responsible for changing the shape of the spleen. Decreased count of WBC and the platelets indicate towards portal hypertension and cirrhosis.
Bleeding: Portal hypertension doesn t let the blood flow in its normal path. It directs the blood to flow through smaller veins. The veins, in turn, swell and burst to cause a massive amount of bleeding.
Apart from these some of the other complications involve jaundice, liver cancer, infections, bone diseases and liver failure.

Diagnosis:
Liver cirrhosis doesn t get detected easily. It is often diagnosed with a routine blood test. Some of the lab tests that can help to identify cirrhosis include blood work to check organ function of liver and kidney. Your doctor might suggest other tests such as MRI scan, CT scan or liver biopsy.

Treatment:
Treatment for the underlying cause of liver cirrhosis is done to keep the disease under control. A doctor might treat you for weight loss, alcohol dependency, complications related to hepatitis, portal hypertension and hepatic encephalopathy. For advanced cases where the liver stops functioning, a doctor might suggest a patient go for a liver transplant.

Liver Cirrhosis - What You Must Know About It?

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