Archive for April, 2009

Treatment of Hypothermia

Hypothermia can be defined as body temperature below 35° Centigrade or 95° Fahrenheit. Hypothermia is again subdivided into 3 subcategories mild hypothermia (35°C – 32.2°C or 95°F – 90°F), moderate hypothermia (less then 32.2°C – 28°C or less then 90°F – 82.4°F) and severe hypothermia (below 28°C or below 82.4°F), depending on severity of hypothermia.

In patients with hypothermia the cardiovascular system and target organs do not usually respond or if responds minimally to most medications. Moreover, repeated doses of medication can cause toxicity during re-warming because of increased binding of drugs to proteins, and there is also impairment in metabolism and excretion of drugs.

Re-warming of hypothermia patient is most important aspect of the treatment. Re-warming can be active and passive depending of the clinical condition of the patient. Passive external re-warming involves covering and insulating the patient in a warm environment with head also covered. The rate of re-warming should be 0.5° to 2.0°C per hour normally. Passive external re-warming is ideal for previously healthy patients who develop acute, mild primary accidental hypothermia and who have sufficient glycogen to support endogenous thermo-genesis. Active re-warming is required when core temperature is less than 32°C, cardiovascular instability, age extremes (very old or very young), CNS dysfunction, hormone insufficiency, or there is suspicion of secondary hypothermia due to some underlying disease. The best way of active re-warming is done with forced-air heating blankets. Other methods of active re-warming are by radiant heat sources and hot packs.

The main aim of therapy of hypothermia should be achieving a mean arterial pressure of at least 60 mmHg in the early stage of treatment. For achieving this objective crystalloids and colloids (normal saline and ringer lactate) should be administered (infused by intra-venous route) and if they fail to raise the blood pressure low-dose dopamine (2–5 ?g/kg per minute) support should be given. For improving tissue perfusion low-dose IV (intra-venous) nitroglycerin should be considered.

Hypothermia may cause atrial arrhythmia and also ventricular arrhythmia. Most of the cases of atrial arrhythmia do not need any treatment, because re-warming will correct atrial arrhythmia unless there is preexisting arrhythmia. For treatment of ventricular arrhythmias bretylium tosylate is the drug generally given (class III ventricular anti-arrhythmic of choice).

Hypothermia can mask sign and symptoms of infection (shaking rigors due to infection may be mistaken for shivering) and empirical treatment with broad spectrum antibiotic should be given in patients with hypothermia, especially in the elderly, neonates, and immune-compromised patients.

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Posted by - April 29, 2009 at 3:39 pm

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Treatment of Premenstrual Tension

Premenstrual tension is as the name suggests certain symptoms (symptoms include headache, gastro-intestinal upset, irritability, lethargy, constipation, frequency of urination, fullness of breasts and some women experience eruption of acne or pimples) few days preceding menstruation. Treatment of premenstrual tension depends on elimination of extra-cellular fluid by a salt free diet and also by limiting water intake for about 10 days preceding menstruation. The treatment regimens used are:

  1. Use of diuretics like chlorthiazide 250 mg single dose or saline purgatives for 10-12 days starting at the onset of the premenstrual symptoms until menstruation starts is very successful.
  2. Use of methyl testosterone 10 mg daily in the last half of the menstrual cycle in certain cases of premenstrual tension and use of large dose of progesterone is useful. But use of progesterone and testosterone can not be explained scientifically because if the theory of water retention as causative factor for premenstrual tension is accepted, than progesterone and testosterone are contra-indicated. 
  3. For treatment symptoms like breast fullness or congestion adequate breast support and fluid restriction and elimination is required. For treating the premenstrual headache (migraine like) ergotamine tartrate in large dose of maximum 10 mg daily and care should be taken so that the dose does not exceed 10 mg per day otherwise there is danger of serious side effects like peripheral vascular spasm (which is seen with all alkaloid drugs).
  4. Many women with premenstrual tension suffer from acne on the body and face and also some skin eruption. Unfortunately the treatment of these conditions is unsatisfactory.

The most important factor in premenstrual tension is psychosomatic and it commonly affects women who are highly strung, introspective and neurotic. The headache or breast tenderness is exaggerated into an obsession of serious nervous disease or the woman becomes that she is having cancer. Due to all these the woman becomes short tempered and her family life and social life get disturbed. There may be tendency to suicide due to extreme depression. Study reveals that the female crime is higher during premenstrual phase of the period. These patients should be treated with patience and reassurance. Psychiatric consultation should be advised for these patients. 

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Posted by - April 20, 2009 at 4:12 pm

Categories: Disease Treatment, Women's Health   Tags:

Prevention of Anthrax

Prevention of anthrax with vaccine is successful and vaccination is recommended if you are at risk of developing anthrax. Prevention of anthrax is required in risky population because if untreated anthrax is almost 100% fatal for inhalational anthrax and more than 20% fatal for cutaneous anthrax. Inhalational anthrax is the form most likely to be responsible for death in a setting of a bioterrorist attack. Patients with inhalational anthrax are not contagious and do not require special isolation.

The first successful anthrax vaccine was developed by Louis Pasteur in 1881 for animals. At present anthrax vaccine is produced from the cell-free culture supernatant of an attenuated, nonencapsulated strain of B. anthracis (known as anthrax vaccine adsorbed or AVA) and is licensed for human use.

As an alternative to AVA, clinical trials for safety in humans and efficacy in animals are currently under way to evaluate the role of recombinant protective antigen of B. anthracis toxins. In preventing the development of clinical disease and death in a post-exposure setting in non-human primates a 2 week trial course of AVA + ciprofloxacin was found to be superior to ciprofloxacin alone.

Chemoprophylaxis: The current recommendation for postexposure prophylaxis is 60 days of antibiotics (Ciprofloxacin or doxycycline); it would be better to include immunization with anthrax vaccine (AVA) if available. There is a potential for B. anthracis to engineer and express penicillin resistance, and due to that, the empirical regimen of antibiotics of choice in this setting is either ciprofloxacin or doxycycline.

The prevention of bioterrorist attacks is the responsibility of the Govt. and not discussed here. But support of the general public is must for the Govt. to prevent bioterrorist attacks successfully.  

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Posted by - April 13, 2009 at 7:44 am

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Brazilian Weight Loss Diet Pills

In the modern civilized society being overweight or obese is a social stigma. Every obese and overweight person tries to lose weight and be fit. For many obese people the dream of being fit remains unfulfilled. Many companies try to cash in on the perfect size or perfect weight dreams by advertising their weight loss products. Scores of weight loss products flood the markets. In selecting a weight loss product you should be careful and do some research about the product or at least the qualities of the ingredients contained in these products. You should always try to buy the weight loss product from a reputed and trusted company otherwise you may be disappointed.

Belissima Sim is one of the most effective (although controversial) diet pills available on the market today. It is a Brazilian diet pills system which is highly effective for weight loss reduction and appetite suppression. It has been scientifically formulated from proven efficient and exotic herbs grown in the rain forests of Brazil under special conditions in order to maximize their beneficial powers. Belissima Sim is made of totally natural ingredients known to suppress the appetite and promote weight loss while acting as a diuretic and metabolism booster at the same time. This weight loss system also provides us with ingredients necessary to enhance the natural function of fat burning, excess water release and appetite suppression. Belissima Sim acts as diuretic and get rid of excess water which in most cases tend to also contribute to weight gain and by releasing water in itself also helps the body get rid of the accumulation of harmful toxic often stored as fat.

Belissima Sim also comes with a detox program made of natural ingredients and because the whole system is composed of high quality and natural ingredients harmful side effect is not expected and these pills can therefore be used safely until the desired weight loss goal has been achieved.

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Posted by - April 12, 2009 at 3:08 am

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Treatment of Anthrax: the Killer Disease

Anthrax can be easily and successfully treated if diagnosed promptly and treatment instituted early and immediately after diagnosis. Anthrax is in the news because of the recent microbial bioterrorist attacks in the United States. Modern science has revealed methods and unleashed a devil of deliberately spreading anthrax and other diseases in ways not appreciated by our ancestors. The combination of basic scientific research, good medical practice, and constant vigil will be required by the public and the Govt. to defend against such attacks.

Clinical features of anthrax: the clinical feature depends on the route of entry of the organism mainly gastrointestinal, cutaneous, and inhalational. Symptoms include cutaneous lesions of papule to eschar (begins as a papule following the introduction of spores through an opening in the skin. This papule then evolves to a painless vesicle followed by the development of a coal-black, necrotic eschar). If the anthrax is due to inhalation the symptoms are fever, malaise, chest pain, abdominal discomfort etc. On chest x-ray there is pleural effusion and widened mediastinum.

Diagnosis of anthrax: Anthrax is diagnosed with laboratory tests like PCR (polymerase chain reaction) test, Wright stain of blood peripheral smear, Gram staining and blood culture of the organism causing anthrax (Bacillus anthracis a gram-positive, nonmotile, spore-forming rod that is found in soil and predominantly causes disease in herbivores like cattle, goats, and sheep).

Treatment of anthrax: penicillin (amoxicillin), ciprofloxacin, and doxycycline are the currently licensed antibiotics for treatment of anthrax. But clindamycin and rifampin can also used as part of treatment regimens and they are also being used to treat anthrax. Treatment is started with penicillin (amoxicillin), ciprofloxacin, and doxycycline till sensitivity results are known and once sensitivity results are known treatment is changed if required.

Post exposure treatment: It is done with Ciprofloxacin, 500 mg, orally twice a day for 60 days or doxycycline 100 mg orally twice a day for 60 days or amoxicillin (likely to be effective if strain penicillin sensitive) 500 mg, orally thrice a day for 60 days.

Treatment of active anthrax: Ciprofloxacin, 500 mg intravenously 12 hourly or doxycycline 100 mg intravenously 12 hourly plus Clindamycin, 900 mg IV 8 hourly and/or rifampin, 300 mg IV 12 hourly. Switch to oral route when stable for60 days total treatment including intravenous route.  

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Posted by - April 12, 2009 at 12:55 am

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Importance of Health insurance

Every individual should heave health insurance and it is one of the necessities of life. You may not need life insurance, but you will need health insurance, because it is certain that you will get sick (suffer from disease of potentially life threatening) many times in your life. Health insurance is very important in life because no matter how healthy you may be, it is for sure that you will suffer from some diseases, may be major or may be minor. So you need to have some health insurance cover.

Insurance is a field many people are not comfortable with as they think it is waste of money. But health insurance facts are different from what many people think about it. Health insurance provides very valuable cover and protection for any health problems, depending on the health insurance policy and specialization of the service the health insurance provide. The benefits of health insurance are peace of mind (most important), protection and health cover, regular health check-up facility etc. to name a few. But while buying health insurance you need to do some research which will be best for you. The lowest premium may not be the cheapest health insurance for you and you should know it. You should always go for the health insurance according to your specific needs and not for the saving a few bucks.   

One of the disadvantages of health insurance as many people think is its cost. But the fact is how much it cost to buy health insurance; it is costlier not to have health insurance. Medical bills are very expensive these days and the cost is skyrocketing and without any hope of ever decreasing. So it is very un-smart not to have health insurance which will prove to be more expensive in the long run.  

 

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Posted by - April 10, 2009 at 3:13 pm

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Treatment of Fever at Home

Fever or pyrexia can be defined as body temperature higher than normal body temperature. According to studies on many healthy individuals 18 to 40 years of age, the mean oral temperature is 36.8° ± 0.4° Centigrade (98.2° ± 0.7° Fahrenheit). Low levels are seen at 6 A.M. and the maximum normal oral temperature at 6 A.M. is 37.2°C (98.9°F). Higher levels of body temperature are seen at 4 to 6 P.M. and the maximum normal oral temperature at 4 to 6 P.M. is 37.7°C (99.9°F). These values define the 99th percentile for healthy individuals. So according to these studies, an A.M. temperature of more than 37.2°C (98.9°F) or a P.M. temperature of more than 37.7°C (99.9°F) could be defined as fever.

For checking the body temperature, always take oral temperature with a thermometer. Keep the thermometer just below tongue for about 2-3 minutes to get the best result. If the patient of fever is a baby and can not cooperate to take oral temperature, you can take temperature from axilla (keep the thermometer for 2-3 minutes in axilla).

The most of the fevers in an individual is due to self limiting infections, such as common viral diseases (e.g. common cold or flu). In these types of common viral infections temperature is usually very close to 100°F (little more than 100°F or little less).

If the fever is less than 100°F it can be tried at home first, by giving cold sponging (wipe the body or the lower and upper limbs with cold water every few minutes till temperature comes down to normal). This simple measure will bring down the temperature to normal in maximum cases with out any medication. If the temperature do not come down with cold sponging for 30 minutes or more than you can give paracetamol (acetaminophen) at the dose of 10 mg/kg body weight orally either tablet or as liquid. This will bring down temperature to normal. If there no reduction in fever, you should consult your doctor. You should also not try to treat fever at home if it is more than 100°F (see your doctor for that).

If you have fever you should drink plenty of fluids as there is evaporation of water through lungs and sweat, which you should replace by drinking plenty of oral fluid (water, fruit juice etc.). 

 

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Posted by - April 7, 2009 at 12:58 pm

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Detoxify your Body with 7-Day Detox

The need to detoxify the body is universally accepted. We need to basically cleanse our body of toxic substances because as they accumulate in our system over time they become harmful to the normal functioning of our metabolism. In today’s stressful lifestyle and with the intake of poor or bad nutrition detoxification is a must.

There are many detox formulas and they act in different ways to cleanse our body of harmful toxins. One of these formulas is the 7 day detox or 7-DCD. This is a unique formula to detoxify the body. As the name indicates it is a seven-day system and typically in order for a detox to really work it should at least be seven days long. We must remember that toxic build-up in our system occurs over time and will not disappear overnight therefore typically results are noticeable within seven days although most people start experiencing effects after the first use. In addition of cleansing the body the 7-day detox has the advantages of helping in losing weight. How? Weight gain is mainly a side effect toxic build-up stored as fat in the body and as we get rid of toxic substances so goes the weight. Some people have reported weight loss of up to 8 kilos.

As you use the 7-day detox or 7-DCD formula you feel better, lighter and your bowel movements become regular and more frequent. You feel trimmer, less bloated and more energized. Because the 7-Day Complete Detox is safe and natural its use is recommended over time.

In order to get maximum benefits from the use of the 7-Day Complete Detox system a healthy diet consisting of fruits, vegetables, whole grain and nuts is strongly recommended although not mandatory. The intake of at least 2 to 3 liters of water is a must as water is essential to the elimination process. Red and smoked meat, refined and canned food, excessive sugar, excess salt, saturated fats (cholesterol), carbonated drinks, coffee, alcohol, food additives, coloring agents, preservatives and smoking should be avoided throughout the duration of the detox. It is important to note that the nicotine in cigarettes is a main source of toxic substances in itself.

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Posted by - April 6, 2009 at 11:32 am

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Treatment of Spasmodic Dysmenorrhea

Treatment of spasmodic dysmenorrhea can be following:

  • Explanation of physiology of menstruation, education and reassurance to the patient are important aspects of management of spasmodic dysmenorrhea.
  • Proper nutrition with balanced nutritious diet, regular physical activity (spasmodic dysmenorrhea is more common among women with sedentary lifestyle), and proper treatment of constipation and adaptation of healthy lifestyle are very much essential in the treatment of spasmodic dysmenorrhea.
  • Initially spasmodic dysmenorrhea should be treated with simple analgesics (pain killers) like aspirin, paracetamol and codeine. Antispasmodics with atropine derivatives, Buscopan (hyoscine bromide), Baralgan etc. are also helpful. With any of the above a tranquillizer is beneficial.
  • Prostaglandin synthetase (inhibit the actions of prostaglandins) inhibitors are successful in the treatment of spasmodic dysmenorrhea. Prostaglandin synthetase inhibitors reduce the activity of myometrium of uterus and reduce pain. The drugs are mefanamic acid (500 mg daily), flufenamic acid (200 mg daily), indomethacin (50 mg daily), and naproxen sodium (200 mg daily) etc. The side effects of these drugs are headache, GIT manifestations like vomiting, reduced menstruation, blurring of vision, acute renal problem etc. due to prolonged use.
  • Endocrine treatment: oral contraceptive (steroids) pills can be of very good use in treatment of dysmenorrhea especially women who want contraception. The cure rate is very good, but the biggest disadvantage is the need of taking contraceptive pills for 21 days for the pain of few days (2 to 3 days) besides side effects and contraindications of oral pills.
  • Danazol a drug which suppress hypothalamic-pituitary-ovarian axis is sometimes helpful in treatment of dysmenorrhea.
  • Surgical dilatation of cervix is also useful in treatment of dysmenorrhea. But the relief may be temporary and excessive and forcible dilatation may lead to complications like premature labor, habitual abortion due to cervical incompetence in subsequent pregnancies. This is therefore not recommended.
  • Presacral sympathectomy is a surgical procedure that is reserved for patients for whom all other measures have failed. But this surgery does not guarantee benefits.
  • Hysterectomy is reserved for the cases for patients there is also pathology pelvis like fibroids and those who have completed their family and do not want any more children.
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Posted by - April 2, 2009 at 12:57 am

Categories: Disease Treatment, Women's Health   Tags: ,