You may have virtually surely got word a superb deal pertaining to Resveratrol antioxidant inside the media as of late, but precisely what are probably by far the most useful Resveratrol supplement sources and the reason why?
It truly is situated in all-natural food products and additionally in nutritionary supplements. Generally the most common source is inside red-colored vino, following the media imparted to us the product was at this moment a wholesome beverage! Which is surely completely correct apart from the adverse side influence from the alcohol.
Resveratrol supplement in contrast to loads of in the other magic health supplements is currently identified in a variety of food goods by way of example raw nuts, vineyard, blueberries, chocolate brown and dark wine. For all those uneasy to attempt vitamin supplements or pills you can ask the query, “where am I able to obtain resveratrol”?
The query, “where am I able to acquire resveratrol” is straightforward to respond to. The major question for you is if you are acquiring the top rated and best item. We’re blessed as of late with lots of selections for all merchandise.
Resveratrol is truly definitely a single of plenty of antiaging products which have turn into seriously well-liked throughout the past handful of years. They all swear to create|to make more power, have age reversing attributes, encourage fat loss, stop many cancers, improve skin tone and substantially additional. You may uncover a fantastic deal of rewards whenever you acquire resveratrol goods.
Numerous wellness food shops, grocery shops and drugstores will possess a huge selection of resveratrol health supplements, generating it easy to acquire resveratrol. Truly a couple of men and women favor to view and read labels of goods they obtain, and staff in well getting food shops are commonly actually knowledgeable about their goods. Added to a wholesome consuming strategy and life style this could have us living nicely more than a hundred years.
Resveratrol just is not a substitute for a wholesome consuming approach and life style. A diet program regime wealthy in low fat protein, vegetables, fruit and grains is your ideal insurance coverage coverage coverage for superb well getting. Exercising and limiting alcohol also go an extended way for feeling your finest. So, whenever you acquire resveratrol have realistic expectations as to what it might possibly do for you. Its antioxidant properties can add an amazing deal for the great wellness and enhancing your immune strategy.
Ahead of you get resveratrol do your evaluation. Read the information that’s undoubtedly written online. There are many medical and nutrition authorities who’ve written articles on resveratrol. Speak together in addition to your well getting provider ahead of beginning a resveratrol program. You wish to create confident that there is certainly no conflict amongst a prescription you might be taking and resveratrol.
In case you wish to extend your life, raise the strength in the heart, shed weight and replenish your skin, a single sure-fire way might be to acquire resveratrol ultra pure anti-oxidants in high concentrations so as to be distinct they’ll deliver an impact.
Scientists situated that the skin within the grape that consists of resveratrol seems to possess a huge function in guarding it from invading bacteria. Whenever you take into consideration shopping for resveratrol you need to take into account that it might nicely possess a positive common impact on your well being.

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Soothe annoyed hemmoroids by producing a do-it-yourself sitz bathtub making use of heat h2o and Epsom salts. This could be completed genuinely quickly by adding a 50 percent cup of plain Epsom salts into a warm, shallow bath. Stay seated within the warm bath for supplied that time permits, and repeat the program of action all via the day, if feasible.

Consider be aware from the salt intake when fighting hemroids. Consuming lots of salt can bring about the physique and piles to swell. In case your food seems also bland without utilizing salt you’ll find a lot of seasonings that could include new and thrilling flavors for the meals with out obtaining the consequences of extra salt.

one approach to aid relieve your hemorrhoids pain is commonly to take a heat bath. The recent drinking water will help relieve the irritation sensation and also the ache. Additionally, any time you consider a shower, that you’re getting rid of the bacteria which may outcome in your piles to worsen, maintaining your physique healthy and happy.

Have an aloevera plant readily available. If you would really like instant relief without having turning to chemical creams, you are able to put an end to a leaf utilizing the plant, and swipe it frivolously across the rectum, or insert it to the rectum. Aloe has been demonstrated to calm inflammation even though simultaneously locating an immediate calming relief.

Standard each and every day physical physical exercise could aid within the prevention and treatment of hemmoroids. In our fast-paced globe it could be challenging to locate time to match exercise into our day but even just a bit will assist. Try employing the stairs rather of the elevator at run. Tend not to do any physical work out that will trigger straining, like lifting weights.

1 making use of the best residence treatment options to aid within the healing, from the painful burning and irritation of hemroids, is usually a sitz bath. An outstanding recipe to get a sitz bathtub is witch hazel. Load your bathtub with warm water and add no much less than a single certain cup of witch hazel for your water. Sit within this heat mixture for 10-15 min’s, a minimum of three occasions each and every day. Inside 3 to 4 days, your hemroids is heading to be gone.

A single within the most prevalent reasons for haemorrhoid formation is persistent bouts of bowel problems. Stopping constipation and pushing rather a little further regular bowel actions can go a lengthy way in steering clear of every internal and external hemmoroids. Appear for all-natural bowel obstruction remedies, for example natural aloe vera vera juice. Aloevera could also be taken in gel or capsule type.

In the early morning, just one utilizing the ideal drinks which you may have is vegetable juice for that hemmoroids. Vegetable juice will present you with the vitamins and minerals that you truly ought to strengthen blood circulation inside your physique and may reduce your degree of harmful toxins. Consume 16-20 ounces of vegetable juice to start your early morning off proper.

The application of ice and right away following that warmth is actually a straightforward and straightforward residence remedy for hemroids. Alternating ice and heat will shrink the hemmroid and aid it to cure. The ice genuinely have to be applied for your affected location for a minimal of 10 minutes every single day, followed by heat, moist warmth for 20 minutes.

Ought to you believe that you just merely have hemroids that aren’t heading away with more than the counter remedies, seek the guidance of the physician. Many therapy selections at the moment are in a position to create into performed inside the workplace with nominal distress or expected comply with up care. You will have the ability to attempt an above the counter remedy initially, but typically comply with up together with your health-related medical medical professional.

When attempting to solution haemorrhoids, be specified you be aware of which medicines you will be using. Most laxatives won’t help with hemorrhoids. They’re designed to help with just one bowel motion. Laxatives may go away you an excellent deal a whole lot much more constipated following that 1st bowel motion. Numerous laxatives commonly will not be produced for assisting with hemroids.

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1. Do not allow Haemorrhoids Mess up Yourself!

Your work or way of life could have an effect in your hemeroid symptoms. When you have a desk occupation or invest a great deal of time sitting even though you’re at residence, make certain to offer your self some aid by strolling about for a couple of minutes every single hour. This requires the direct stress off your hemmoroids. Also, in case your work involves a great deal of hefty lifting, attempt to exhale as you tolerate the brunt in the load. Holding your breathing puts stress around the hemmeroid flare-ups and may possibly result in them to become far more painful.

Eat fiber! One of the most effective options to treating hemroids is by adding far more dietary fiber for your diet! Fibers will preserve your stoolgentle and decrease bulk that will support lessen stressing. Scientific studies have proven that the boost of fiber inside a diet plan will increase the distress of itchiness and discomfort associated with hemmroid flare-ups.

If you’re susceptible hemroid flare-ups you could want to appear into your day-to-day schedule. If you come across oneself in the course of to frequently then attempt to decrease time intervals in the course of which you will be sitting. Extreme sitting can be a we ok identified lead to for haemorrhoids. If sitting can’t be prevented consider standing upright breaks.

When dealing with hemmorhoid flare-ups, you need to not take a seat or stand up for also lengthy. You need to attempt to vary among sitting and standing all through the same day. Whenever you sit or stand up for lengthy periods of your time, you are increasing the pressure on your hemmoroids. This could lead to the hemmorhoid flare-ups to turn into even worse.

If you are suffering from this problem you might need to sustain even greater hygeine than regular. Contemplate putting money in a few sort of wet toilet paper rather than working with the normal dry one particular, as well as be sure to thoroughly clean really well 2 times or even additional instances in the course of on a daily basis.

If you have problems with hemroids or you would like to keep away from them in the long term, then it really is suggested you enhance your consumption of fiber. This may assist you to stay away from constipation and pressuring when heading towards the bathroom, that are the key components that lead to hemeroid development. Stay away from too much wheat dietary fiber on the other hand. It is fairly coarse and may make you uncomfortable.

If you’re searching for rapid relief of the haemorrhoid flare up, it is best to look at a few of the over-the-counter goods readily available just for that purpose. You can find lotions, suppositories, gels and also pads that contain drugs that lessen the location. Various other medication for example Tylenol and Nuprin can help to lessen the pain too.

Hemorrhoids could possibly be a very embarrassing challenge but are rather widespread. When you need to have to deal with them, there are lots of more than the countertop treatments. If they may be severe and will not go absent, you can even possess a medical doctor intervene but you shouldn’t allow them to go with no treatment at any time since they are effortlessly curable.

Once you have haemorrhoids, you may wish to sustain appropriate bowel actions at all times. Certainly one of the techniques that you can assist in this really is to eat an eating plan that is certainly higher in soluble fiber. Fibers will stop working the meals inside your body and allow you to to feel much more peaceful.

A good solution to treating a serious hemorroid dilemma is by utilizing the botanical herb horse chestnut. This supplement was utilised in the past as being a natural remedy to relieve swelling and irritation. It may be taken as tea or perhaps in supplement type. It might also be used outwardly like a pack. Prior to getting any health supplement, make certain that you just speak together with your druggist or physician.

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We want to find out a possibility to the trouble that you can determine in the Green Tea. Therefore, when someone talks about the Green tea , you see this person is ready to receive a lot of questions. When you need to reduction the unwellness or you want to burn excess body fats and control your appetite you suppose to drink this Best Green Tea. You can discover this green tea on the internet and the store or you ask vendor to send you this product by recommendation..

Therefore, I find out this green tea in whatsoever grocery store. That means about five years ago, I drunkl this Best Green Tea. Because, the individuals are saying that this green tea is a best weight loss tea. With the Green Tea you can all the problems that you can find as sicknesses. Hence, it is real essential to order a Best Green Tea. This product is real efficient and powerful and you can find it on the internet and whatever grocery store..

Well I’m going to have to come across as pretentious here and say genuine Chinese green tea….from China. I’ve currently got two which I utilize. One lot I got as two big bags from a friend who brought them over from China. The freshest most crisp tasting green tea I’ve ever tried. The Chinese in reality know how to do green tea well.

There is one box that many individuals know it on the name of Nottingham, let me tell you one thing this green tea could come on form the leaves, powder or Gunpowder, some people view it as darkers and dirtier with more bits……

With a taste fantastic, this green tea is really excellent and real powerful with its effectiveness, it has a great dose as a smoky taste, wow!1 this is great!!!.

many individuals called this Best Green Tea a Healthiest green tea. Do you know why? Because this green tea comes from to the tea plant. Every year this green tea crop varies..

When you have possibility to purchase this green tea from time to time you suppose to drink it every day because this product could better aid you to the illnesses as : headache, heart disease and others..Hence, it is very important to drink this product. This green tea is one of the best weight loss teas…..

If you want to determine this Best Green Tea in a best season you suppose to wait for the spring, because in the month of March/April the sun is not So hot. Thence, it is the season that you find out you can better discover this Best Green tea….This product has his proper season to discover it in big amount……

Ultimately, we know that this Best Green Tea is from to camellia sinensis plant.Therefore , if you get best weight loss green tea you suppose to accept to utilize the leaves of green tea. You can discover the effectiveness in this green tea. Do not worry for its price the leaves of green tea are real effective and powerful too when you put numerous hot water on numerous leaves green tea after a few minutes you can drink this green tea with some sugar……

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Measles is a most contagious disease in children characterized by skin rash, cough, runny nose, sore throat, red eyes caused by paramyxovirus. It is a fetal disease if not treated properly. In 2008 ,197000 children died of measles. Vaccination has significantly reduced the mortality rate in the world .

What causes the Measles?

Measles is caused by paramyxovirus (meales virus). Virus is transmitted though droplets from the nose, mouth and throat of a infected individual. When infected individual cough,sneeze and talks virus droplets into the air, where normal people can inhale them and get infected .

What are the risk factor for getting Measles?

1. Unimmunized children
2. Children less than 1 year
3. Low socioeconomic status
4. Vitamin A deficiency
5. Who received immunoglobulin during measles vaccination

What are the signs and symptoms of Measles ?  

1. High fever (104 to 105 F)
2. Red eyes
3. Cough
4. Photophobia
5. Runny nose
6. Sore throat
7. Loss of appetite
8. Rash : Appears 3-5 days of first symptoms and signs. Rash start from the head and spread other parts of the body . It is present either macules(flat,discolored) or as papules (solid, raised red) .
9. Koplik’s spots( Tiny bluish-white spots inside the check)

How is the measles diagnosed?

Diagnosis relies on patients history and physical examination . In doubt cases diagnosis is confirmed by blood test for antibody of virus (IgM) and virus culture.

What are the complications of the measles ?

1. Ear infection
2. Sinusitis
3. Bronchitis
4. Laryngitis
5. Pneumonia
6. Encephalitis

Miscarriage,premature delivery in pregnant women.

1. Bleeding( due to low platelets count)

How is Measles managed ?

There is no cure of measles,but some treatment relives symptoms which includes :

1. Acetaminophen(paracetamol) or ibuprofen to reduce fever and relief pain. Don t use the aspirin for the children because of the risk of developing Reye’s syndrome.
2. Plenty of fluid
3. Vitamin A supplement
4. Humidified air
5. Bed rest
6. Isolate the children from others children .
7. Antibiotic is used those who have the complications likes pneumonia, ear infection due to bacterial infection.

How is a measles prevented?

1. Immunization of MMR( measles-mumps-rubella ) vaccine is the the most effective way to prevent the measles . First dose of vaccine is given at 12-15 moths of age followed by second dose of immunization when the child is 4-6 years of old (vaccine is contraindicated who have egg allergies) .
2. Isolation of the patient( Measles is contagious from the four days before to fours days after rash)
3. Immune globulin is used for high-risk peoples who are exposed to measles includes HIV patients, child younger than 1 years old and pregnant women.

What the prognosis of Measles?

Most of the individual have good prognosis. 0.2% individual will die and few individual have sequels like panencephalitis and pneumonia .

References:

• http://www.emedicinehealth.com
• http://en.wikipedia.org
• http://www.mayoclinic.com
• http://www.medicinenet.com
• http://www.ncbi.nlm.nih.gov
• http://www.ehealthmd.com
• http://www.umm.edu

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Infertility is defined when a couple not being able to get pregnant after at least 1 year of unprotected sex (using no birth control methods) .Infertility affects about 10% of people in the reproductive age. Men and women both affects equally.

What causes the Infertility ?

There are different causes of infertility in men and female.

Infertility in female is due to following reasons:

1. Unable to survive fertilized egg or embryo in the uterus
2. Unable to move eggs from the ovary.
3. Unable to produced eggs

Infertility in men is due to following reasons : .

1. Low sperm count
2. Decreased movement of sperm

Causes of infertility in female includes :

1. Polycystic ovary syndrome(POCS)
2. Ovarian cysts
3. Myomas or fibroid
4. Polyps
5. Antiphospholipid syndrome
6. Anorexia nervosa( an eating disorder consisting of loss of appetite due to and emotional states such as anxiety,irritation , anger or fear. In anorexia nervosa there is no real loss of appetite, but rather a refusal to eat or an aberration in eating patterns, so that the term anorexia may be misnomer)
7. Obesity
8. Stress, depression
9. Excessive exercise
10. Dyspareunia
11. Turners syndrome
12. Defects of the uterus and cervix
13. Endometriosis
14. Pelvic inflammatory disease
15. Adrenal hormone deficiency
16. Thyroid hormone deficiency
17. Prolactinoma
18. Autoimmune disease
19. Scar tissue after surgery
20. Diabetes
21. Hypertension
22. Urinary tract infection
23. Smoking, heroin, cocaine and heavy alcohol consumption
24. Antibiotics , Antidepressants , acetaminophen , estrogen supplement
25. Chemotherapy
26. Radiation
27. Premature menopause

Causes of infertility in male includes :

1. Genetic abnormalities
2. Erectile dysfunction
3. Dyspareunia
4. Impotence
5. Retrograde ejaculation
6. No sperm
7. Anti-sperm antibodies
8. Cystic fibrosis
9. Varicocele
10. Undescended testis
11. Deficiency of testosterone
12. Klinefelter,s syndrome
13. Sexually transmitted disease includes chlamydia and gonorrhea.
14. Exposure to radiation and chemical
15. Smoking, heroin, cocaine and heavy alcohol consumption
16. Chemotherapy
17. Post operation scar
18. Hypothyroidism
19. Diabetes
20. Hypertension
21. Urinary tract infection
22. Spinal cord injuries
23. Drugs such as cimetidine, nitrofurantion, spironolactone

What are the signs and symptoms of infertility ?

Main signs and symptoms of infertility is the inability for a couple to get pregnant after at least 1 year of unprotected sex (using no birth control methods).

How is a infertility diagnosed ?

Diagnosis relies on clinical findings ,laboratory tests and radiological imaging.

Laboratory tests includes :

1. Serum progesterone analysis
2. Thyroid function tests
3. Luteinizing hormone test
4. Testosterone level
5. FSH and LH level
6. Estrogen level
7. Genetic testing
8. Blood glucose analysis
9. Complete blood test

Radiological imaging includes:

1. Hysterosalpingography
2. Pelvic ultrasound
3. Scrotal ultrasound
4. Pelvic CT scan
5. Laparoscopy

How is a infertility managed?

Management of infertility depends upon causes , duration of infertility and age of the women.

Treatment of infertility in women :

1. Drugs used for those who have ovulation disorders includes clomiphene, hMG( human menopausal gonadotropin , FSH( follicle-stimulation hormone), HCG(Human chorionic gonadotropin hormone), Gn-RH ( Gonadotropin-releasing hormone), metformin, Bromocriptine.
2. Treatment of STD s
3. Treatment of diabetes, hypertension, hypothyroidism.
4. Surgical management of tumors, Myomas , fibroid and Polyps
5. Assisted reproductive technology (ART is the procedure that involves manipulation of eggs or sperm to establish pregnancy) is indicated when women has a healthy uterus but medical treatment fails to achieve a pregnancy. ART includes IVF( in vitro fertilization, surgical sperm aspiration , ICSI( intracytoplasmic sperm injection), ZIFT( zygote intrafallopian transfer).

Treamtment of infertility in men :

1. Treatment of impotence
2. Treatment of STD s
3. Treatment of diabetes, hypertension and hypothyroidism
4. Surgical management of undescended testis, Varicocele .
5. ART

What is the prognosis of infertility?

About 60 % of couple become pregnant after appropriate treatments( exclude ART techniques) . Couple who are candidate of ART success rate is up to 27%.

References:

• http://www.emedicinehealth.com
• http://en.wikipedia.org
• http://www.mayoclinic.com
• http://www.medicinenet.com
• http://www.ncbi.nlm.nih.gov
• http://www.ehealthmd.com
• http://www.umm.edu
• http://www.fertilitycommunity.com
• http://www.cdc.gov

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1. Premature ovarian failure
2. In vitro fertilization
3. HELLP Syndrome

Scabies is a condition characterized by itchy skin caused by the mite ,Sarcoptes scabiei. It is highly contagious. The word scabies come form the Latin word scabere, which means to scratch.

What caused the Scabies?

Scabies is caused by parasite,called Sarcoptes scabiei. The mites make borrow into the skin where it deposit its egg. Eggs get mature in 21 days and spread to other ares of the body or skin of other people. Close contact or sharing clothes of infected individual can spread the mites.

What are the signs and symptoms of Scabies?

1. Itching in skin usually at night( results form allergic reaction to the mites and its eggs)
2. Rashes in the skin
3. Blister in the skin
4. Burrows or tracks appear in between fingers, around the waist, on the inner elbow, around breast, around the waist, in armpit, on knee , scalp, neck, soles of the feet

What are the differential diagnosis of Scabies?

1. Syphilis
2. Dermatitis
3. Urticaria
4. Ectoparasites

How is a Scabies diagnosed?

Diagnosis relies on patients history, physical examination and laboratory examination .

Presence of mites or its eggs under a microscope confirm the diagnosis.

How is a Scabies managed?

1. Wash clots and bed cloths in hot water
2. Personal hygiene
3. Permethrine 5% cream which kill the mites applied in whole body except in face two times in a week
4. Lindane not safe for children younger than 2 years .
5. Ivermectin with the dose of 200 micrograms per kg of body weight per mouth as a single dose and repeat is two weeks later also shown effective.
6. Antihistamines likes diphenhydramine ,cetrizine help to control the itching.
7. Treat sexual partner or closed relatives as well.

What is the prognosis of Scabies?

Prognosis is excellent.

References:

• http://www.emedicinehealth.com
• http://en.wikipedia.org
• http://www.mayoclinic.com
• http://www.medicinenet.com
• http://www.ncbi.nlm.nih.gov
• Harrison’s Principles of Internal Medicine, 17^th edition.
• Davidson’s Principles and Practice of Medicine, 20th Edition

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Dengue fever is an acute febrile disease characterized by high fever, headache, skin rash and joint pains caused by the dengue virus which are transmitted by Aedes aegypti mosquito. Dengue fever is also known as breakbone or dandy fever.

What causes a dengue fever?

Dengue fever is caused by any of four different type of dengue virus(DENV). Viruses are transmitted by Aedes aegypti mosquito and sometimes by Aedes albopictus mosquito .

What are the signs and symptoms of Dengue fever?

1. High fever (104 F) with chills
2. Headache
3. Fatigue
4. Joint pain
5. Muscle pain
6. Rash over most of the body
7. Pain during eye movement
8. Nausea and vomiting
9. Abdominal pain
10. Swollen lymph nodes

What are the complication of a Dengue fever?

1. Dengue hemorrhagic fever, which is characterize by high fever, bleeding from mouth and nose , bruising and ultimately death of the patients.
2. Dengue shock syndrome, is the most severe complication of a dengue fever characterize by severe abdominal pain, severe vomiting, massive bleeding, dyspnea , sudden drop of blood pressure and death.
3. Dissemination intravascular coagulation (DIC), is characterized by abnormal reduction in the elements involved in blood clotting due to their use in widespread intravascular clotting.

How is a Dengue fever diagnosed?

Diagnosis relies on patient history, physical examination, laboratory test and radiological imaging

1. ELISA to isolate the virus and detects the IgM and IgG antibody of dengue virus.
2. Reverse trancriptase-polymerase chain reaction can detect the antigens of dengue virus .
3. Complete blood test shows , thrombocytopenia and leukopenia.
4. Radiological imaging includes X-ray , CT and MRI shows pleural effusion , intracranial bleeding and cerebral edema.

How is a Dengue fever managed?

Treatment depends upon the severity and the form of the disease .

In mild form of the disease.

1. Drink plenty of fluids
2. Acetaminophen( paracetamol) or ibuprofen to reduce fever and relief pain.

In severe form of the disease:

1. Hospital admission
2. Monitor vitals regularly
3. O2 supply
4. Intravenous fluid replacement or transfusion of blood
5. Correct electrolyte and acid-base balance
6. Heparin can be used to prevent DIC
7. Antiviral medicine is not available

What is the prognosis of a Dengue fever?

Prognosis is excellent with early treatment but becomes worse if complications develop.

References:

• http://www.emedicinehealth.com
• http://en.wikipedia.org
• http://www.mayoclinic.com
• http://www.medicinenet.com
• http://www.ncbi.nlm.nih.gov
• http://www.medicalnewstoday.com
• http://emedicine.medscape.com
• Harrison’s Principles of Internal Medicine, 17^th edition.
• Davidson’s Principles and Practice of Medicine, 20th Edition

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Tonsillitis is an inflammation of the tonsils ( A small, rounded mass of lymphoid tissue mainly found on the upper rear wall of the mouth cavity, they are of fair size in childhood but usually shrink after puberty ) characterized by sore throat, difficulty swallowing and fever caused by virus and bacteria.

What causes the tonsillitis?

Tonsillitis is caused by:

1. Common cold viruses including adenovirus, influenza , coronavirus, rhinovirus, respiratory syncytial virus.
2. Other viruses including herpes simplex virus, Epstein-Barr virus, cytomegalovirus and HIV.
3. Bacterial infection includes Group A beta-hemolytic streptococcus , staphylococcus aureus, streptococcus pneumoniae, chlamydia pneumoniae, pertussis, diphtheria and gonorrhea.

What are the signs and symptoms of tonsillitis?

1. Sore throat
2. Difficulty in swallowing
3. Pain during swallowing
4. Red, swollen tonsils
5. White or yellow patches on the tonsils
6. Cough
7. Runny nose
8. Nasal congestion
9. Redness of eyes
10. Fever
11. Headache
12. Nausea and vomiting
13. Bad breath
14. Stiff neck
15. Hoarseness
16. Refusal to eat
17. Rash

What are the complications of tonsillitis?

1. Difficulty in breathing
2. Tonsillar abscess( collection of pus behind a tonsil)
3. Peritonsillar abscess( quinsy)
4. Rheumatic fever
5. Post-streptococcal glomerulonephritis
6. Septicemia

How is a tonsillitis diagnosed ?

Diagnosis relies on history , physical examination and laboratory tests.

Laboratory tests includes:

1. Complete blood test
2. Throat swab and culture
3. Rapid strep test
4. Mononucleosis test

How is a tonsillitis managed?

1. Plenty of rest
2. Plenty of fluids
3. Avoid smoking , alcohol and caffeine
4. Gargle with saltwater
5. Ibuprofen or acetaminophen (paracetamol) is used to control a fever and decreased throat pain .
6. Penicillin with the dosage of ( 250 mg two or three times a day for children and 500mg two or there times a day for adults for 10 days) is the first line treatment for bacterial tonsillitis . People who are allergic to penicillin erythromycin or azithromycin is used.
7. Surgical removal of tonsil( tonsillectomy ) is indicated who have recurring tonsillitis, chronic tonsillitis, obstructed sleep apnea , dyspnea and peritonsillar abscess that refuse to respond to the antibiotic treatment.

What is the prognosis of tonsillitis?

Prognosis is excellent with early treatment .

References:

• http://www.emedicinehealth.com
• http://en.wikipedia.org
• http://www.mayoclinic.com
• http://www.medicinenet.com
• http://www.ncbi.nlm.nih.gov
• http://www.netdoctor.co.uk
• Harrison’s Principles of Internal Medicine, 17^th edition.
• Davidson’s Principles and Practice of Medicine, 20th Edition

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Cholelithiasis are hard, stone like deposits inside the gallbladder. Cholelithiasis is the most common gastrointestinal disorder leading to surgical management. The size of the stone range from as small as a grain of sand to as large as a golf  ball.

What are the types of Cholelithiasis?

Gallstone is divided into following types:

1. Cholesterol Gallstone(80% of total gallstone) : It is radiolucent . Mainly contain cholesterol.
2. Pigment Gallstone(20% of total gallstone): It is radiopaque. Mainly contain calcium bilirubinate.

What is the pathogenesis of Cholelithiasis?

1. Cholesterol stones is formed when the ratio of cholesterol to phospholipids or bile salts is increased , bile salts is supersaturated with cholesterol results in crystallizes and forms a focus for stone formation .
2. Pigments stones is formed due to the crystallization of calcium bilirubinate.

What are the risks factor for cholelithiasis?

1. Female
2. More than 40 years
3. Obese individual
4. Pregnant women
5. Hemolytic anemia
6. Sickle cell anemia
7. Liver cirrhosis
8. Biliary tract infection
9. Diabetes
10. Eating high fat, high cholesterol , low fiber diet
11. Taking birth control pills
12. Taking drugs which contain estrogen.
13. Rapid weight loss
14. Fasting for long time
15. Long time intravenous feeding

What are the signs and symptoms cholelithiasis?

Many people (60%-80% )who have gallstones are asymptomatic( have never had signs and symptoms) . Symptoms commonly occur when stone blocks cystic or common bile duct , which includes:

1. Biliary colic ( Acute paroxysmal pain in upper right quadrant of the abdomen )
2. Pain spread to the back and right shoulder
3. Pain occur after fatty meal
4. Fever
5. Jaundice
6. Dyspepsia
7. Flatulence
8. Food intolerance
9. Nausea and vomiting
10. Abdominal fullness
11. Clay colored stools

What are the complications of cholelithiasis?

1. Acute Cholecystitis
2. Chronic Cholecystitis
3. Empyema of the gall bladder
4. Mucocele( dilation of the ball bladder with accumulated mucous secretion)
5. Mirizzi,s syndrome ( Mirizzi syndrome is a condition when common hepatic duct obstruction caused by compression from an impacted stone in the hartmann’s pouch or in cystic duct. )
6. Biliary obstruction
7. Acute Cholangitis
8. Acute Pancreatitis
9. Gallstone ileus ( Intestinal obstruction due to gall stone)
10. Gallbladder cancer

How is a cholelithiasis diagnosed ?

Diagnosis relies on history and physical examination and laboratory test with confirmatory radiological studies which includes:

1. Abdominal ultrasound ( 90% of gallstone are visible in USG)
2. Abdominal X-ray ( 10-15% of gallstone are diagnosed by x-ray
3. Abdominal CT and MRI scan
4. ERCP( endoscopic retrograde cholangiopancreatography)
5. HIDA scan(Hepatoiminodiacetic acid)
6. PTCA( Percutaneous transhepatic cholangiogram)
7. Laboratory tests includes Liver function tests, Serum lipase , Bilirubin and complete blood test.

How is a cholelithiasis managed ?

1. Asymptomatic Gallstones don’t required treatment. Cholecystectomy(open cholecystectomy and laparoscopic cholecystectomy) is being performed for those patients who developed symptoms or complications .Prophylactic cholecystectomy is considered in diabetes patients, congenital Hemolytic anemia , those due to undergo bariatric surgery. Other treatment for cholelithiasis includes:
2. ERCP( treat gallstones in the common bile duct)
3. Lithotripsy ( Lithotripsy is done for those who cant have surgery)
4. Medication which includes chenodeoxycholic acids (CDCA) or ursodeoxycholic acid (UCDA) are prescribed to dissolve cholesterol gallstones.

What is the prognosis of cholelithiasis?

Prognosis is excellent with early treatment.

References:

1. Sabiston textbook of surgery 18th edition
2. The Washington manual of surgery, 5th edition.
3. emedicine.medscape.com
4. http://www.medicinenet.com
5. http://en.wikipedia.org
6. http://www.uptodate.com
7. http://www.ncbi.nlm.nih.gov

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Typhoid fever also known as enteric fever , is a life-threatening infectious disease characterized by progressive high fever , profuse sweating, rash and gastroenteritis caused by Salmonella typhi.

What causes the Typhoid fever?

Typhoid fever is caused by bacterias includes Salmonella typhi and Salmonella parathyphi. Bacteria is transmitted though fecal-oral route .

What are the signs and symptoms of Typhoid fever?

Signs and symptoms are developed gradually

Clinical presentation in first week

1. Slowly progressive fever as high as 104 degree Fahrenheit.(stepladder fever pattern)
2. Headache
3. Profuse sweating
4. Decrease appetite
5. Constipation or diarrhea
6. Fatigue and weakness
7. Sore throat
8. Abdominal pain
9. Insomnia
10. Confusion
11. Psychosis
12. Jaundice
13. Sharp right lower quadrant pain
14. Joint pain , muscle pain
15. Rose spots
16. Urinary retention
17. Hematuria( blood in urine)

Clinical presentation in second week

1. Continuous high fever
2. Weight loss
3. Distention of abdomen
4. Malaise , confusion and delirium
5. Dicrotic Pulse ( a pulse characterized by two peaks, the second peak occurring in diastole )
6. Diarrhea ( pea soup like)

Clinical presentation in third week

1. Delirious
2. Motionless and exhausted eyes
3. Life-threatening complication may developed.

Clinical presentation in forth week

1. This is the recovery phase
2. Decreased fever
3. Improvement of other signs and symptoms

What are the complications of Typhoid fever?

1. Intestinal bleeding
2. Intestinal perforation ( most common complication may developed in the third week of illness)
3. Myocarditis
4. Pancreatitis
5. Pneumonia
6. Osteomyelitis
7. Meningitis
8. Cholecystitis

How is a Typhoid fever diagnosed?

Diagnosis relies on clinical findings, laboratory tests and radiological imaging.

Laboratory tests includes

1. Complete blood count (CBC) shows increased white blood cells and low platelet count. .
2. Blood culture isolate S.typhi or S.parathyphi , widely considered 100% specific.
3. Widal test shows salmonella antibodies against antigens H-falgellar and O-somatic .
4. Polymerase chain reaction(PCR) is to detect the H1-d flagellin gene of S typhi.
5. ELISA urine test shows S.typhi or S.parathyphi.
6. Bone marrow aspiration and culture of BMA is the most sensitive to detect S.typhi .

Radiological imaging includes X-ray, CT and MRI scan is useful in bowel perforation.

How is a Typhoid fever managed ?

1. Ciprofloxacin with the dose of 250-500 mg PO twice a day for 7-14 days is the drugs of choice where resistance is uncommon .If there is resistance to Ciprofloxacin third generation cephalosporin includes cefotaxime or ceftriaxone is the drugs of choice. Ampicillin, chloramphenicol , Bactrim are the alternatives to treat the typhoid fever.
2. Drinking a lot of fluid
3. Eating a hearty diet
4. Complete rest
5. Surgical management is indicated in cases of intestinal perforation.
6. Cholecystectomy is indicated in carrier state where antibiotics fails to eradicated the bacteria.

What is the prevention of typhoid fever ?

1. Maintain good hygiene
2. Avoid drinking contaminated water
3. Improved sanitation
4. Choose hot foods
5. Isolation of infected people
6. Vaccines are recommended for travel the endemic area ( vaccine is not 100% effective)

What is the prognosis of typhoid fever ?

Prognosis is excellent with early treatment but becomes worse if complications develop. 3%-4% developed as carries of thyroid fever .

References:

• http://www.emedicinehealth.com
• http://en.wikipedia.org
• http://www.mayoclinic.com
• http://emedicine.medscape.com
• http://www.medicinenet.com
• http://www.ncbi.nlm.nih.gov
• http://www.netdoctor.co.uk
• Harrison’s Principles of Internal Medicine, 17^th edition.
• Davidson’s Principles and Practice of Medicine, 20th Edition

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Diabetes insipidus is the condition characterized by polydipsia ( excessive thirst ) and polyuria ( excessive urine volume) due to decreased secretion or resistance to the antidiuretic hormone (ADH) .

What are the types of Diabetes Insipidus ?

Diabetes insipidus is divided into central and nephrogenic diabetes insipidus . Central DI is due to lack of ADH secretion where nephrogenic diabetes insipidus is caused by a failure of the kidneys to respond to antidiuretic hormone.

What causes the Diabetes Insipidus ?

Central DI is caused by Pituitary or hypothalamus gland destruction which includes :

1. Surgery
2. Tumor
3. Meningitis
4. Inflammation
5. Head injury

Nephrogenic DI is caused by:

1. Drugs includes lithium, demeclocycline, amphotericin B
2. Genetic disorder
3. Hypercalcemia ( high levels of calcium in the body)
4. Polycystic kidney disease

Other causes of diabetes insipidus includes :

1. Lung cancer , Leukemia, Lymphoma
2. Histiocytosis X, anorexia nervosa, sarcoidosis
3. Hypoxic encephalopathy
4. Aneurysms
5. Artriovenous malformation

What are the signs and symptoms of Diabetes insipidus ?

1. Polydipsia ( excessive thirst)
2. Polyuria ( excessive urination , 2.5 liters to 15 liter of urination per day )
3. Nocturia ( urinary frequency at night )
4. Fever
5. Vomiting
6. Diarrhea
7. Dry skin
8. Cold extremities
9. Crying, growth retardation , irritability , weight loss in infants
10. Anorexia, Enuresis ( Bed wetting) , growth defects in children

How is a Diabetes insipidus diagnosed ?

Diagnosis relies on clinical findings, laboratory test and radiological imaging .

1. Routine urine test: urine specific gravity 1.005 or less and osmolality of urine is less than 200 mOsm/kg .
2. Water deprivation test
3. Radiological imaging includes MRI may show abnormality of pituitary or hypothalamus gland .

“Desmopressin stimulation tests is used to differentiate between the central and nephrogenic diabetes insipidus. “

How is a Diabetes insipidus managed ?

Management depends upon the types of the diabetes insipidus.

Treatment of central DI includes:

1. Balanced salt and water intake
2. Avoid dehydration
3. Desmopressin is the drug of choice with the dose of 5-10 U SC per 3-6 hours.

Treatment of nephrogenic DI includes :

1. Low salt diet
2. Stop medication that causes the nephrogenic DI.
3. Hydrochlorothiazide with the dose of 25-50 mg PO per day.
4. Chlorpropamide, carbamazepine and indomethacin are alternatives of Hydrochlorothiazide to treat DI.

What is the prognosis of Diabetes insipidus ?

Prognosis is excellent .

References:

• http://www.emedicinehealth.com
• http://en.wikipedia.org
• http://www.mayoclinic.com
• http://emedicine.medscape.com
• http://www.medicinenet.com
• http://www.ncbi.nlm.nih.gov
• Harrison’s Principles of Internal Medicine, 17^th edition.
• Davidson’s Principles and Practice of Medicine, 20th Edition

No related posts.

Well.. .my idea is always that before you decide to set yourself on one of these paths do a little clinical shadowing and several lab research.

Some definitions first….

1. MD: Signifies Doctor of Medicine, a doctor’s qualification in medicine
2. PhD: Is the highest diploma obtained at a college or university, usually requiring 3 to 5 years of original study in a specific field of study.
3. MD/PhD: refers to an education consisting of both the medical training of a medical doctor (MD or DO) with the rigor of a scientific specialist (PhD)

You could also consider to get involved in some clinical research. This will likely offer you a taste of the different fields. Some MDs do clinical research, if you get interested in that, you would not need an MD/PhD.

You actually should gain some upfront exposure prior to make any decisions. Neither clinical work nor lab bench effort is just what it may appear like in theory. You need to get your hands dirty. Attempt to request information, find out about them, and have several tastes of each one.

I believe it’s more easy to find a personality niche when you are delighted by the specific work you’re doing every single day, rather than attempt to enjoy doing work you hate, even if you fit the “typical profile” of the career.

Generally a double degree is perfect for those people who are interested in both, basically. However, you will possibly not wind up doing most of the actual bench work if you are an MD/PhD. The MD/PhD who’s the P.I. of the science lab I currently work for NEVER does some of the actual experiments we currently do, he simply covers administrational stuff and discusses problems/ideas along with his henchmen.

All his time through the week is spent on clinical work. I am not sure that will be the way it always works, but that is my own experience. However , if you happen to be equally interested in both, then I would still think an MD/PhD may be worth considering.

MD/PhD will place you at some advantage in grant-writing while you’re a new researcher. (Eventually, the degree matters less because research recruiters assess you according to your actual accomplishments.)

Imagine that studying scientific research can be easier if you have been trained like a physician. This advantage isn’t definitely worth the extra 3 years, but it’s somewhat of an advantage. It provides the flexibleness to view patients if you’d prefer. A slight majority of the MD/PhD’s I have seen usually do not, but some do and in any case all of them could. It could aid in the pursuit of an academic position too.

And also you? What are your positives and negatives of choosing a MD, MD/PhD or PhD profession?

Who am I ?: S. Ochoa is writing for the clinical research training courses blog, her personal and non-commercial in nature pastime blog to produce free recommendations for clinical research training newbie’s/experts to assist them get a new profession.

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