Categories
Disease & Condition Exercise & Fitness First Aid Food & Nutrition Food List Health Advice List of vaccines Mother & Child Health Symptoms and cure of the disease খাদ্য ও পুষ্টি খাদ্য তালিকা টিকার তালিকা প্রাথমিক চিকিৎসা ব্যায়াম ও খাদ্য নিয়ন্ত্রণ মা ও শিশু স্বাস্থ্য রোগ ব্যাধি রোগের লক্ষন ও প্রতিকার স্বাস্থ্য পরামর্শ

অক্সিজেন সরবরাহকারী প্রতিষ্ঠানের ঠিকানা ও ফোন নাম্বার।

Oxygencylinderbd
01714585817
Dhaka-1212
H#2, R#Madani Ave, Vatara

Nursinghomecarebd
01719661366
nursinghomecare2012@gmail.com
Gulshan-2
Dhaka, Vatara-40

Medical oxygen cylinder refill rent sell support in Bangladesh
880 1994-888999
House #3, Block #J, Dhaka 1212, Bangladesh

Medical Oxygen Cylinder Price BD
+880 1716-671752
Dhaka 1212, Bangladesh

Verbalbd
+88 01819-311676
120/A, R.S Bhaban (2nd Floor), Motijheel C/A, Dhaka-1000

Oxygen Concentrator Price in Bangladesh
+880 1819-311676
Verbal Maa House, Road 17, house-5, Block-C, Dhaka 1219, Bangladesh

Medical oxygen home service company in dhaka bangladesh
+880 1682-000000
shebaagencybd@gmail.com
Muktobangla Shoping Complex, Level:09-233, Dhaka 1216

Oxygen generator concentrator cylinder home support in Bangladesh
nursinghomesupportbd
info@nursinghomesupportbd.com
+880 1940-101080
+880195-999-5312
+880184-031-9980
213(Ground Floor), Tajlen Road, Middle Paikpara, Mirpur-1, Dhaka-1216

Spectra Oxygen Limited – Dhaka Depot
780, 27 Bosila Setu Road, Dhaka, Bangladesh
+880 1713-173634
https://sol.com.bd/
info@sol.com.bd

Medical Equipment – Oxygen Cylinder Refill Rent Sell Supports in Dhaka Bangladesh. Nursing Home Care
+880 1714-585817
Dhaka 1212, Bangladesh

Oxygen Cylinder BD
+880 1718-018733
+8801911290527
nursingcareservicebd@gmail.com
House no: 12, Block: A, Flat: 2D, Ave No: 1, Section: 10, Dhaka 1216, Bangladesh
www.oxygencylinderhomedelivery.com
House no: 12, Block: A, Flat: 2D, Avenue: 1, Section: 10, Mirpur, Dhaka-1216, Bangladesh

OXYGEN CYLINDER HOME SERVICE
20 Nayabari, Sajid Plaza, Vatara, Natun Bazar-12, Dhaka, Bangladesh
880 1716-089838

Timely Product Ltd
235 Satarkul Rd, Dhaka 1212, Bangladesh
+880 1712-444336
https://timelyproduct.com/
support@timelyproduct.com

Oxygen Bd EBL
+880 1613-203103
Dhaka 1216, Bangladesh

Islam Oxygen (Pvt) Ltd
+880 1313-204420
Tarabo, Rupgonj, Bangladesh
info@islamoxygen.com; islamoxygen@gmail.com; islamoxygensales@gmail.com
https://islamoxygen.com/

Oxygen Cylinder BD
+880 1714-558407
GULSHAN-2, NOTUN BAZAR, VATARA Dhaka, 1212, Bangladesh
info@oxygencylinder.live

Maisha Oxygen Cylinder Supplier
+880 1707-372001
11, parbati nagar, Thana Rd, Savar Union 1340, Bangladesh
https://maishacare.com/
info@maishacare.com
+8801315092095

24 Oxygen Home Support In Dhaka
+880 1716-671752
Mirpur ,1 Muktha Bangla Shopping Complex, Dhaka 1216, Bangladesh

Oxygen Sale BD
House No: 12, Road No: 6, Turag City, Mirpur: 1 Dhaka, 1216, Bangladesh
+880 1766-149264
https://oxygensalebd.com/
info@oxygensalebd.com

Union Oxygen Limited
Motijheel C/A, Suite# D-3, Nahar Mansion (3rd Floor), Dhaka, 1000, Bangladesh
+880 1617-727102
https://uolbd.business.site

M/S HALIMA ENTERPRISE
+880 1718-054477

Shema Oxygen Oxico Ltd.
Dhaka – Chittagong Hwy, Bhatiari, Bangladesh
+880 3127-80177

Kabir Oxygen Limited
Bhatiari, Bangladesh
+880 31-711501

Bismillah Enterprise
125 Katalgong, Chattogram, Bangladesh
+880 1856-859670

Linde Bangladesh Ltd.
285 Tejgaon Industrial Area Dhaka – 1208 Bangladesh
+880.2.8870322-27
Phone: 08 000 303 303 (toll free)
care.line.bd@linde.com
http://www.linde.com.bd/

M/S Padma Trading
Kuwaish Sonjog Sarak, Ward No. 3, Nayar Hat, Oxygen, Baksu Nagar, Bayezid, Chattogram 4213, Bangladesh
+880 1812-948747

Jaya Bijaya Engineering
348 Commerce College Road, Chattogram, Bangladesh
+880 1817-707178

Chottogram Device Center-CDC
1715, Jakir Hussain Road, Khulshi, Chattogram 4200, Bangladesh
+880 1912-760350

Taj Traders Pvt. Ltd
389 Nabab Siraj Ud Daula Rd, Chattogram, Bangladesh
+880 1711-802930
01844 071861
ttpl.tajscientific@gmail.com
http://www.tajscientific.com/

M/s. Jalalabad Tredars
+880 1711-982619
BOC Company Gate, Hazi Wazed Ali Lane, Adjacent Oxygen, Hathazari Road, Oxyzen, Chattogram 4213, Bangladesh

Medical Tools
Rd No. 1, Chattogram, Bangladesh
+880 1979-311707
info@medicaltoolsbd.com
medicaltoolsbd.com/public/

Dwip pharmecy
+880 1815-918028
Chattogram, Bangladesh

Islam Oxygen (Pvt.) Ltd. Chattogram Depot.
+880 1755-588096
Abdul Karim Rd, Chattogram 4213, Bangladesh

Oxygen supplier Sylhet
+880 1682-000000
https://oxygenbd.com/
3100, Bangladesh
8801795228222
shebaagencybd@gmail.com

Sylhet Oxygen Center
Bypass Road, Sylhet, Bangladesh
+880 1641-791929

M/s. Tems Corporation
Bypass Road, Homayun Roshid Chottor, Mominkhola, Sylhet 3100, Bangladesh
+880 1612-388585

Categories
Disease & Condition English Symptoms and cure of the disease

Back pain

Back pain is a common symptom that affects 60–80% of people at some time in their lives.

The prognosis (outcome) is generally good. After 2 days, 30% are better and 90% have recovered by 6 weeks. Recurrences  of  pain  may  occur  and  about  10–15%  of patients  go  on  to  develop  chronic  back  pain  that  may  be difficult  to  treat.  Psychological  elements,  such  as  job  dissatisfaction,  depression  and  anxiety,  are  important  risk factor.

Causes of Back pain

  • Mechanical back pain
  • Prolapsed intervertebral  disc
  • Osteoarthritis
  • Vertebral fracture
  • Spinal stenosis
  • Paget’s disease
  • Spondylolysis
  • Bone metastases etc.

Others causes

Renal colic, Pyelonephritis

Pelvic inflammatory disease

Pancreatitis

Peptic ulcer disease

 

What causes back pain in children?

These injuries are usually caused by activity and overuse. Scheuermann’s disease causes pain that is not severe enough to limit activity. It is the second most common cause of back pain in children and young adults. Your child may have a rounded spine.

Can Stomach pain be caused by back pain?

A back injury or injury to the spine can cause pain to radiate in the abdomen. Also, a pinched nerve can not only cause pain to the entire area served by that nerve, but it can also cause various stomach functioning problems as well. Inflammation of the colon, or colitis, is very often associated with lower back pain.

Why do girls have back pain?

Lower back pain during your period, or primary dysmenorrhea, is caused by contractions in the uterus.

What causes muscle spasms in the lower back?        

Back spasms can be the result of injuries to the muscles, tendons, and ligaments in the back or it can be related to more serious medical conditions. Heavy lifting is a common cause of back spasms. Any activity that puts excessive strain on the muscles and ligaments in the lower back can cause an injury.

 

Symptoms of mechanical low back pain

  • Pain  varies  with  physical  activity  (improved  with  rest)
  • Sudden  onset,  precipitated  by  lifting  or  bending
  • Recurrent  episodes
  • Pain  limited  to  back  or  upper  leg
  • No  clear-cut  nerve  root  distribution
  • No  systemic  features
  • Prognosis  good  (90%  recovery  at  6  wks)

 

Red flags for possible spinal pathology (Danger features)

  • Age:  presentation  <  20  yrs  or  >  55  yrs
  • Character:  constant,  progressive  pain  unrelieved  by rest
  • Location:  thoracic  pain
  • Past  medical  history:  carcinoma,  tuberculosis,  HIV,  systemic corticosteroid  use,  osteoporosis
  • Constitutional:  systemic  upset,  sweats,  weight  loss
  • Major  trauma

Investigations

Investigations are not required in patients with acute mechanical back pain.  Those  with  persistent  pain  (> 6  weeks)  or  red  flags  should  undergo further  investigations such as MRI, X-Ray, Bone scan and some blood tests.

What are the treatment of LBP?

General

  • Self-limiting nature of the condition.
  • Stay active, exercise is helpful rather than damaging
  • Medication if necessary (preferably at fixed time intervals).
    • Paracetamol
    • NSAID like ibuprofen, indomethacin, naproxen.

Regular use, improved mobility, and facilitate exercise

  • Doctor may consider opioids, muscle relaxant medicine
  • Bed rest is not helpful it increase the risk of chronic disability
  • For pain relief doctor may consider spinal manipulation
  • Lumbar supports, back-specific exercises, traction, acupuncture, epidural or facet injections not helpful for mechanical back pain
  • Physiotherapy may be required if not improved within 6 weeks
  • Low dose Tricyclic anti-depressant drugs will help pain, sleep and mood

Specific

Treatment of other causes should be done accordingly with involving other special departments as per doctor advice.

What should we do for back spasms?

Warm water compression helps to promote healing by drawing healthy blood cells to the area of the back spasm. Heat also relaxes the nerves and muscle fibers. Try an ice & heat alternate cycle after the first 72 hours. Some physical therapists suggest using heat applications before stretching and ice after stretching.

What is the cause of muscle spasms?

Spasms may affect many different types of muscles in the body, leading to many different symptoms. Spasms of skeletal muscles are most common and are often due to overuse, dehydration, and electrolyte abnormalities. The spasm occurs abruptly, is painful, and is usually short-lived.

How do you get rid of a muscle spasm?

Natural Treatments for Muscle Spasms.

  • Prevent Electrolyte Imbalances. A potassium and/or magnesium deficiency can contribute to muscle spasms.
  • Stretch and Massage Your Muscles.
  • Stay Hydrated.
  • Use Ice or Heat Packs on Sensitive Muscles
  • Fix Your Posture.
  • Take a Bath with Epsom Salt.

How long does it take to heal from a back spasm?

After the first three days, you can start using heat to loosen muscle tightness and increase blood flow. Waiting at least 72 hours after your spasms start allows the initial swelling and inflammation to go down, and moist heat is generally preferred to dry because it reduces the potential for dehydration.

Dr. Md Elias Bhuiyan

MBBS, FCPS (Medicine)

Registrar

Bangladesh Medical College & Hospital, Dhaka.

Categories
Disease & Condition English Symptoms and cure of the disease

Haemorrhoids (piles)

Haemorrhoids, also known as piles, are swellings containing enlarged blood vessels found inside or around the bottom (the rectum and anus).

When symptoms do occur, they may include:

  • bleeding after passing a stool – the blood is usually bright red
  • itchy bottom
  • a lump hanging down outside of the anus, which may need to be pushed back in after passing a stool
  • a mucus discharge after passing a stool
  • soreness, redness and swelling around your anus

Haemorrhoids aren’t usually painful, unless their blood supply slows down or is interrupted.

When to seek medical advice

See your GP if you have persistent or severe symptoms of haemorrhoids. You should always get any rectal bleeding checked so your doctor can rule out more potentially serious causes.

The symptoms of haemorrhoids often clear up on their own, or by using simple treatments that can be bought from a pharmacy without a prescription.

Speak to your GP if your symptoms don’t get better or you experience pain or bleeding.

Your GP can often diagnose haemorrhoids using a simple internal examination of your back passage, although they may need to refer you to a colorectal specialist for diagnosis and treatment.

Some people with haemorrhoids are reluctant to see their GP. But there’s no need to be embarrassed – GPs are very used to diagnosing and treating haemorrhoids.

What causes haemorrhoids?

The exact cause of haemorrhoids is unclear, but they’re associated with increased pressure in the blood vessels in and around your anus. This pressure can cause theblood vessels in your back passage to become swollen and inflamed.

Many cases are thought to be caused by too much straining on the toilet as a result of prolonged constipation. This is often caused by a lack of fibre in a person’s diet.

Chronic (long-term) diarrhoea can also make you more vulnerable to getting haemorrhoids.

Other factors that might increase your risk of developing haemorrhoids include:

  • being overweight or obese
  • age – as you get older, your body’s supporting tissues get weaker, increasing your risk of haemorrhoids
  • being pregnant – this can place increased pressure on your pelvic blood vessels, causing them to enlarge; read more about piles in pregnancy
  • having a family history of haemorrhoids
  • regularly lifting heavy objects
  • a persistent cough or repeated vomiting
  • sitting down for long periods of time

Preventing and treating haemorrhoids

Haemorrhoid symptoms often settle down after a few days without needing treatment. Haemorrhoids that occur during pregnancy often get better after giving birth.

Making lifestyle changes to reduce the strain on the blood vessels in and around your anus is often recommended.

These can include:

  • gradually increasing the amount of fibre in your diet – good sources of fibre include fruit, vegetables, wholegrain rice, wholewheat pasta and bread, pulses and beans, seeds, nuts and oats
  • drinking plenty of fluid – particularly water, but avoiding or cutting down on caffeine and alcohol
  • not delaying going to the toilet – ignoring the urge to empty your bowels can make your stools harder and drier, which can lead to straining when you do go to the toilet
  • avoiding medication that causes constipation – such as painkillers that contain codeine
  • losing weight if you’re overweight
  • exercising regularly – this can help prevent constipation, reduce your blood pressure, and help you lose weight

 

These measures can also reduce the risk of haemorrhoids returning or even developing in the first place.

Treatment

Medication that you apply directly to your back passage (topical treatments) or tablets bought from a pharmacy or prescribed by your GP may ease your symptoms and make it easier for you to pass stools.

More severe cases need to be treated by a specialist.

One possible treatment is rubber band ligation. Rubber band ligation can be performed in the doctor’s surgery or outpatient clinic and does not require hospital admission.

The procedure involves placing a small rubber band at the base of the haemorrhoid with a special applicator. The rubber band cuts off the blood supply to the haemorrhoid, which eventually falls off after a few days.

Injection of a substance that makes the blood in the haemorrhoid clot is another option (sclerotherapy).

The most serious cases are third-degree haemorrhoids. These protrude through the back passage and can require surgical removal or ‘haemorrhoidectomy’. Such operations are successful in 90 per cent of cases. However, many third-degree haemorrhoids shrink and become symptom-free without surgical treatment.

Categories
Disease & Condition Symptoms and cure of the disease

Wrinkles

Wrinkles, a natural part of aging, are most prominent on sun-exposed skin, such as the face, neck, hands and forearms.

Symptoms

Wrinkles are the lines and creases that form in your skin. Some wrinkles can become deep crevices or furrows and may be especially noticeable around your eyes, mouth and neck.

When to see a doctor

If you’re concerned about the appearance of your skin, see a dermatologist. He or she can assess your skin and help you create a personalized skin care plan. A dermatologist can also recommend medical wrinkle treatments.

Causes

Wrinkles are caused by a combination of factors — some you can control, others you can’t:

  • As you get older, your skin naturally becomes less elastic and more fragile. Decreased production of natural oils dries your skin and makes it appear more wrinkled. Fat in the deeper layers of your skin diminishes. This causes loose, saggy skin and more-pronounced lines and crevices.
  • Exposure to ultraviolet (UV) light.
  • Smoking.
  • Repeated facial expressions. .

Treatments and drugs

If your wrinkles bother you, you have many options to help smooth them or reduce their appearance. Wrinkle treatments include:

Medications

  • Topical retinoids. Derived from vitamin A, retinoids — such as tretinoin and tazarotene — that you apply to your skin may reduce fine wrinkles, splotches and skin roughness.
  • Nonprescription wrinkle creams.

Surgical procedures and other techniques

  • Laser, light source and radiofrequency treatments.
  • Chemical peel.
  • Dermabrasion.
  • Microdermabrasion
  • Botulinum toxin type A (Botox).
  • Soft tissue fillers.
  • Skin tightening.
  • Face-lift.

Prevention

Here are ways to make the most of your skin’s appearance:

  • Protect your skin from the sun. Protect your skin — and prevent future wrinkles — by limiting the time you spend in the sun and always wearing protective clothing, such as wide-brimmed hats, long-sleeved shirts and sunglasses. Also, use sunscreen when outdoors, even during winter.
  • Use products with built-in sunscreen.
  • Use moisturizers.
  • Don’t smoke.
  • Eat a healthy diet.
  • Protect your skin from the sun.
  • Use products with built-in sunscreen.
  • Protect your skin from the sun.
  • Use products with built-in sunscreen.
  • Use moisturizers.
  • Don’t smoke.
  • Eat a healthy diet.
  • Use moisturizers.
  • Don’t smoke.
  • Eat a healthy diet.

 

Categories
Disease & Condition Symptoms and cure of the disease

Whooping Cough

Whooping cough (pertussis) is a highly contagious respiratory tract infection. In many people, it’s marked by a severe hacking cough followed by a high-pitched intake of breath that sounds like “whoop.”

Symptoms

Once you become infected with whooping cough, it takes about seven to 10 days for signs and symptoms to appear, though it can sometimes take longer. They’re usually mild at first and resemble those of a common cold:

  • Runny nose
  • Nasal congestion
  • Red, watery eyes
  • Fever
  • Cough

After a week or two, signs and symptoms worsen. Thick mucus accumulates inside your airways, causing uncontrollable coughing. Severe and prolonged coughing attacks may:

  • Provoke vomiting
  • Result in a red or blue face
  • Cause extreme fatigue
  • End with a high-pitched “whoop” sound during the next breath of air

When to see a doctor

Call your doctor if prolonged coughing spells cause you or your child to:

  • Vomit
  • Turn red or blue
  • Seem to be struggling to breathe or have noticeable pauses in breathing
  • Inhale with a whooping sound

Causes

Whooping cough is caused by bacteria. When an infected person coughs or sneezes, tiny germ-laden droplets are sprayed into the air and breathed into the lungs of anyone who happens to be nearby.

Risk factors

Whooping cough is thought to be on the rise for two main reasons. The whooping cough vaccine you receive as a child eventually wears off. This leaves most teenagers and adults susceptible to the infection during an outbreak — and there continue to be regular outbreaks.

In addition, children aren’t fully immune to whooping cough until they’ve received at least three shots, leaving those 6 months and younger at greatest risk of contracting the infection.

Complications

Teens and adults often recover from whooping cough with no problems. When complications occur, they tend to be side effects of the strenuous coughing, such as:

  • Bruised or cracked ribs
  • Abdominal hernias
  • Broken blood vessels in the skin or the whites of your eyes

Infants

In infants — especially those under 6 months of age — complications from whooping cough are more severe and may include:

  • Pneumonia
  • Slowed or stopped breathing
  • Dehydration or weight loss due to feeding difficulties
  • Seizures
  • Brain damage

Because infants and toddlers are at greatest risk of complications from whooping cough, they’re more likely to need treatment in a hospital. Complications can be life-threatening for infants younger than 6 months old.

Tests and diagnosis

Diagnosing whooping cough in its early stages can be difficult because the signs and symptoms resemble those of other common respiratory illnesses, such as a cold, the flu or bronchitis.

Sometimes, doctors can diagnose whooping cough simply by asking about symptoms and listening to the cough. Medical tests may be needed to confirm the diagnosis. Such tests may include:

  • A nose or throat culture and test.
  • Blood tests.
  • A chest X-ray.

Treatments and drugs

Infants are typically hospitalized for treatment because whooping cough is more dangerous for that age group. If your child can’t keep down liquids or food, intravenous fluids may be necessary. Your child will also be isolated from others to prevent the infection from spreading.

Treatment for older children and adults usually can be managed at home.

Medications

Antibiotics kill the bacteria causing whooping cough and help speed recovery. Family members may be given preventive antibiotics.

Unfortunately, not much is available to relieve the cough. Over-the-counter cough medicines, for instance, have little effect on whooping cough and are discouraged.

Lifestyle and home remedies

The following tips on dealing with coughing spells apply to anyone being treated for whooping cough at home:

  • Get plenty of rest.
  • Drink plenty of fluids.
  • Eat smaller meals.
  • Clean the air.
  • Prevent transmission.

Prevention

The best way to prevent whooping cough is with the pertussis vaccine, which doctors often give in combination with vaccines against two other serious diseases — diphtheria and tetanus. Doctors recommend beginning vaccination during infancy.

The vaccine consists of a series of five injections, typically given to children at these ages:

  • 2 months
  • 4 months
  • 6 months
  • 15 to 18 months
  • 4 to 6 years

Vaccine side effects

Side effects of the vaccine are usually mild and may include fever, crankiness, headache, fatigue or soreness at the site of the injection.

Booster shots

  • Because immunity from the pertussis vaccine tends to wane by age 11, doctors recommend a booster shot at that age to protect against whooping cough (pertussis), diphtheria and tetanus.
  • Some varieties of the every-10-year tetanus and diphtheria vaccine also include protection against whooping cough (pertussis). This vaccine will also reduce the risk of your transmitting whooping cough to infants.
  • Pregnant women. Health experts now recommend that pregnant women receive the pertussis vaccine between 27 and 36 weeks of gestation. This may also give some protection to the infant during the first few months of life.

 

Categories
Disease & Condition

Vitiligo

Vitiligo is a disease that causes the loss of skin color in blotches. The extent and rate of color loss from vitiligo is unpredictable. It can affect the skin on any part of your body. It may also affect hair, the inside of the mouth and even the eyes.

Symptoms

Vitiligo signs include:

  • Skin discoloration
  • Premature whitening or graying of the hair on your scalp, eyelashes, eyebrows or beard (usually before age 35)
  • Loss of color in the tissues that line the inside of your mouth and nose (mucous membranes)
  • Loss of or change in color of the inner layer of the eyeball (retina)
  • Discolored patches around the armpits, navel, genitals and rectum

When to see a doctor

See your doctor if areas of your skin, hair or eyes lose coloring. Vitiligo has no cure. But treatment may help to stop or slow the discoloring process and return some color to your skin.

Causes

  • A disorder in which your immune system attacks and destroys the melanocytes in the skin
  • Family history (heredity)
  • A trigger event, such as sunburn, stress or exposure to industrial chemicals

Complications

People with vitiligo may be at increased risk of:

  • Social or psychological distress
  • Sunburn and skin cancer
  • Eye problems, such as inflammation of the iris (iritis)
  • Hearing loss
  • Side effects due to treatment, such as dry skin and itching

Tests and diagnosis

Medical history and exam

If your doctor suspects you have vitiligo, he or she will ask about your medical history, examine you and try to rule out other medical problems, such as dermatitis or psoriasis. He or she may use a special lamp to shine ultraviolet light onto the skin to determine whether you have vitiligo.

Skin biopsy and blood draw

In addition to gathering your personal and family medical history and examining your skin, your doctor may:

  • Take a small sample (biopsy) of the affected skin
  • Draw blood for lab tests

Other exams

Your doctor may recommend that you see an eye specialist (ophthalmologist), who may check for inflammation in your eye (uveitis). Your doctor may also suggest that you see a hearing specialist (audiologist) to undergo a hearing evaluation because people with vitiligo may have an increased risk of hearing loss.

Treatments and drugs

Many treatments are available to help restore skin color or even out skin tone. Results vary and are unpredictable. Some treatments have serious side effects. So your doctor may suggest that you first try improving the appearance of your skin by applying self-tanning products or makeup.

Medications

No drug can stop the process of vitiligo — the loss of pigment cells (melanocytes). But some drugs, used alone or with light therapy, can help improve your skin’s appearance.

Creams that control inflammation. A topical corticosteroid may help return color to (repigment) your skin, particularly if you start using it early in the disease.A form of vitamin D. Topical calcipotriene is a cream that can be used with corticosteroids or ultraviolet light. Possible sideffects include dry skin, rash and itching.

Medications that affect the immune system. Ointments containing tacrolimus or pimecrolimus (calcineurin inhibitors) may be effective for people with small areas of depigmentation, especially on the face and neck.

Combined medication and light therapy. This treatment combines a drug called psoralen with light therapy (photochemotherapy) to return color to the light patches.

Light therapy. This treatment uses narrow band UVB light.

Laser therapy. This procedure brings color back to patches of light skin by treating them with an excimer laser, which uses a specific wavelength of UVB light

Removing the remaining color (depigmentation)

Surgery

Skin grafting.

Blister grafting.

Tattooing (micropigmentation)

Lifestyle and home remedies

Protect your skin from the sun and artificial sources of UV light

Conceal affected skin.

Don’t get a tattoo

 

Categories
Disease & Condition

Vertigo

Vertigo is a type of dizziness and refers to a false sensation that oneself or the surroundings are moving or spinning (usually accompanied by nausea and loss of balance) that is a result of a mismatch between vestibular, visual, and somatosensory systems.

Types

  • Central (cerebral cortex, cerebellum, brainstem) – eg, cerebrovascular disease, migraine, multiple sclerosis, acoustic neuroma, diplopia, alcohol intoxication.
  • Peripheral (vestibular labyrinth, semicircular canals or vestibular nerve) – eg, viral labyrinthitis, vestibular neuritis, benign paroxysmal positional vertigo (BPPV), Ménière’s disease, motion sickness, ototoxicity (eg, gentamicin), herpes zoster (Ramsay Hunt syndrome).

Causes

Causes of vertigo may include:

  • Viral labyrinthitis.
  • Vestibular neuritis (often misdiagnosed as labyrinthitis).
  • Benign paroxysmal positional vertigo.
  • Vertebrobasilar ischaemia
  • Eustachian tube dysfunction (causes mild vertigo).
  • Ménière’s disease
  • Chronic otitis media.
  • Drugs: salicylates, quinine, aminoglycosides.
  • Vestibularmigraine.
  • Epilepsy the likely diagnosis if vertigo is associated with loss of consciousness.
  • Acoustic neuroma may cause mild vertigo, but associated with unilateral sensorineuraldeafness and tinnitus.
  • Nasopharyngeal carcinoma
  • Neurological:brain stem cerebrovascular accident,multiple sclerosis,syringobulbia,cerebellar tumours
  • Following head injury

Assessment

Complaints of dizzy spells are very common and are used by patients to describe many different sensations. The key to making a diagnosis is to find out exactly what the patient means by dizzy and then decide whether or not this represents vertigo. With a clear description of vertigo, the precipitants and time course (onset, frequency, and duration of attacks) are often diagnostic.

Assess the nature of the dizziness

  • Assess whether the person has vertigo rather than presyncope, disequilibrium (imbalance), or light-headedness. Vertigo usually causes rotatory or spinning symptoms.

Assess any associated symptoms

  • Ear symptoms – eg, hearing loss, ear discharge, tinnitus.
  • Neurological symptoms – eg, headache, diplopia, visual disturbance, dysarthria or dysphagia, paraesthesia, muscle weakness or ataxia.
  • Autonomic symptoms – eg, nausea and vomiting, sweating or palpitations.
  • Symptoms suggesting migraine aura – eg, visual or olfactory symptoms.

Assess any relevant medical history

  • Recent upper respiratory tract infection or ear infection (may suggest a diagnosis of vestibular neuronitis or labyrinthitis).
  • History of migraine.
  • Head trauma or recent labyrinthitis suggests BPPV.
  • Direct trauma to the ear, which may indicate possible perilymph fistula.
  • Both anxiety or depression can aggravate dizziness or vertigo.
  • Cardiovascular risk factors increase the likelihood that stroke may be the cause of vertigo.
  • Some drugs (eg, aminoglycosides, furosemide, antidepressants, antipsychotics, anticonvulsants) may cause vertigo.
  • Acute intoxication with alcohol may cause vertigo.

Examination

  • Neurological examination including gait and their ability to stand unaided, cranial nerves, cerebellar function, signs of peripheral neuropathy and any indication of a cerebrovascular event.
  • Ear examination including signs of infection, discharge and cholesteatoma.
  • Eye examination: nystagmus (common in acute vertigo), fundoscopy.

Investigations

  • No investigations are likely to be performed in primary care.
  • Secondary care investigations include:
    • Audiometry for cochlear function.
    • Vestibular function: electronystagmography, calorimetry and brain stem-evoked responses.
    • Possible neurological cause: CT or MRI.
    • Electroencephalography (EEG): epilepsy.
    • Lumbar puncture: possible multiple sclerosis.
    • Syphilis serology.

Management

Explanation and reassurance are important as anxiety exacerbates vertigo. Persistent disequilibrium should be overcome by central adaptation, but anxiety may prevent this.

General advice

  • Advise the person not to drive when they are dizzy, or if they are likely to experience an episode of vertigo while driving.
  • The person should inform their employer if their vertigo poses a risk in the workplace, eg using ladders, operating heavy machinery or driving.
  • Discuss the risk of falling in the home during an episode of vertigo and suggest measures

Drug treatment

Consider offering symptomatic drug treatment with prochlorperazine, cinnarizine, cyclizine or promethazine (antihistamines) for no longer than one week. It is important that the person should stop symptomatic treatment 48 hours before seeing a specialist.

Rehabilitation programmes

  • There is evidence to support the efficacy of vestibular rehabilitation programmes for unilateral peripheral vestibular disorder; a simple programme including patient education and home-based exercises can be sufficient.
  • Booklet based vestibular rehabilitation for chronic dizziness has been shown to be a simple and cost effective means of improving patient reported outcomes in primary care.
  • Balance rehabilitation is important and beneficial in elderly people, in whom dizziness is invariably multifactorial.
  • A recent Cochrane review confirmed the efficacy of Epley’s manoeuvre and then a period of post-Epley postural restriction (eg, upright head posture for 48 hours) in treating BPPV.

Surgery

Surgical options for Ménière’s disease include endolymphatic sac surgery, vestibular nerve section, micropressure therapy and labyrinthectomy.

Complications

  • Increased risk of falls, especially in the elderly.
  • Vertigo may confine people to their homes, making them fearful or depressed.

Prognosis

  • Follow-up studies have shown BPPV rates of 50% at five years and a persistence of dizziness related to anxiety in almost a third of patients one year after vestibular neuritis

 

Categories
Disease & Condition

Vaginitis

Vaginitis is an inflammation of the vagina that can result in discharge, itching and pain. The cause is usually a change in the normal balance of vaginal bacteria or an infection. Vaginitis can also result from reduced estrogen levels after menopause.

The most common types of vaginitis are:

  • Bacterial vaginosis,
  • Yeast infections
  • Trichomoniasis
  • Vaginal atrophy (atrophic vaginitis)

Treatment depends on the type of vaginitis you have.

Symptoms

Vaginitis signs and symptoms may include:

  • Change in color, odor or amount of discharge from your vagina
  • Vaginal itching or irritation
  • Pain during intercourse
  • Painful urination
  • Light vaginal bleeding or spotting

When to see a doctor

See your doctor if you develop any unusual vaginal discomfort, especially if:

  • You’ve never had a vaginal infection. Seeing your doctor can establish the cause and help you learn to identify the signs and symptoms.
  • You’ve had vaginal infections before, but in this case, it seems different.
  • You’ve had multiple sex partners or a recent new partner. You could have a sexually transmitted infection. The signs and symptoms of some sexually transmitted infections are similar to those of a yeast infection or bacterial vaginosis.
  • You’ve completed a course of over-the-counter anti-yeast medication and your symptoms persist, you have a fever, or you have a particularly unpleasant vaginal odor. These are signs the infection may be from something other than yeast or from a resistant strain of yeast.

Risk factors

Factors that increase your risk of developing vaginitis include:

  • Hormonal changes, such as those associated with pregnancy, birth control pills or menopause
  • Sexual activity
  • Having a sexually transmitted infection
  • Medications, such as antibiotics and steroids
  • Uncontrolled diabetes
  • Use of hygiene products such as bubble bath, vaginal spray or vaginal deodorant
  • Douching
  • Wearing damp or tight-fitting clothing
  • Using an intrauterine device (IUD) for birth control

Complications

Generally, vaginal infections don’t cause serious complications. In pregnant women, however, symptomatic bacterial vaginosis and trichomoniasis have been associated with premature deliveries and low birth weight babies. Women with trichomoniasis or bacterial vaginosis are also at a greater risk of acquiring HIV and other sexually transmitted infections.

Tests and diagnosis

To diagnose vaginitis, your doctor may:

  • Review your medical history, including your history of vaginal or sexually transmitted infections.
  • Perform a pelvic exam. During the pelvic exam, your doctor may collect a sample of cervical or vaginal discharge for lab testing to confirm what kind of vaginitis you have.

Treatments and drugs

A variety of organisms and conditions can cause vaginitis, so treatment targets the specific cause:

  • Bacterial vaginosis. For this type of vaginitis, your doctor may prescribe metronidazole tablets that you take by mouth, metronidazole gel that you apply to your vagina or clindamycin cream that you apply to your vagina. Medications are usually used once or twice a day for five to seven days.
  • Yeast infections. Yeast infections usually are treated with an antifungal cream or suppository, such as miconazole , clotrimazole or tioconazole. Yeast infections may also be treated with a prescription oral antifungal medication, such as fluconazole .
  • Your doctor may prescribe metronidazole or tinidazole tablets.
  • Thinning of vaginal lining (vaginal atrophy). Estrogen — in the form of vaginal creams, tablets or rings — can effectively treat atrophic vaginitis. This treatment is available by prescription from your doctor.
  • Noninfectious vaginitis. To treat this type of vaginitis, you need to pinpoint the source of the irritation and avoid it. Possible sources include new soap, laundry detergent, sanitary napkins or tampons. Your doctor may prescribe topical estrogen, such as a cream, to relieve your symptoms.

Lifestyle and home remedies

You’ll need prescription medication to treat trichomoniasis, bacterial vaginosis and vaginal atrophy. If you know you have a yeast infection, you may go ahead with treatment on your own, taking these steps:

  • Use an over-the-counter medication specifically for yeast infections.
  • Apply a cold compression

Prevention

Good hygiene may prevent some types of vaginitis from recurring and may relieve some symptoms:

  • Avoid baths, hot tubs and whirlpool spas. Rinse soap from your outer genital area after a shower, and dry the area well to prevent irritation. Don’t use scented or harsh soaps, such as those with deodorant or antibacterial action.
  • Avoid irritants. These include scented tampons and pads.
  • Wipe from front to back after using the toilet. Doing so avoids spreading fecal bacteria to your vagina.

Other things that may help prevent vaginitis include:

  • Don’t douche. Your vagina doesn’t require cleansing other than normal bathing. Repetitive douching disrupts the normal organisms that reside in the vagina and can actually increase your risk of vaginal infection. Douching won’t clear up a vaginal infection.
  • Use a latex condom. Both male and female latex condoms may help you avoid infections spread by sexual contact.
  • Wear cotton underwear. Also wear pantyhose with a cotton crotch. If you feel comfortable without it, skip wearing underwear to bed. Yeast thrives in moist environments.

 

Categories
Disease & Condition

Urinary Tract Infection

A urinary tract infection (UTI) is an infection in any part of your urinary system — your kidneys, ureters, bladder and urethra. Most infections involve the lower urinary tract — the bladder and the urethra.Women are at greater risk of developing a UTI than men.

Symptoms

Urinary tract infections don’t always cause signs and symptoms, but when they do they may include:

  • A strong, persistent urge to urinate
  • A burning sensation when urinating
  • Passing frequent, small amounts of urine
  • Urine that appears cloudy
  • Urine that appears red, bright pink or cola-colored — a sign of blood in the urine
  • Strong-smelling urine
  • Pelvic pain

UTIs may be overlooked or mistaken for other conditions in older adults.

Causes

  • Infection of the bladder (cystitis). This type of UTI is usually caused by Escherichia coli (E. coli), a type of bacteria commonly found in the gastrointestinal (GI) tract. However, sometimes other bacteria are responsible. Sexual intercourse may lead to cystitis, but you don’t have to be sexually active to develop it.
  • Infection of the urethra (urethritis). This type of UTI can occur when GI bacteria spread from the anus to the urethra. Also, because the female urethra is close to the vagina, sexually transmitted infections, such as herpes, gonorrhea, chlamydia and mycoplasma, can cause urethritis

Complications

  • Recurrent infections, especially in women who experience three or more UTIs.
  • Permanent kidney damage from an acute or chronic kidney infection (pyelonephritis) due to an untreated UTI.
  • Increased risk in pregnant women of delivering low birth weight or premature infants.
  • Urethral narrowing (stricture) in men from recurrent urethritis, previously seen with gonococcal urethritis.
  • Sepsis, a potentially life-threatening complication of an infection, especially if the infection works its way up your urinary tract to your kidneys.

Tests and diagnosis

Tests and procedures used to diagnose urinary tract infections include:

  • Analyzing a urine sample
  • Growing urinary tract bacteria in a lab
  • Creating images of your urinary tract
  • Using a scope to see inside your bladder

Treatments and drugs

Antibiotics usually are the first line treatment for urinary tract infections. Which drugs are prescribed and for how long depend on your health condition and the type of bacteria found in your urine.

Drugs commonly recommended for simple UTIs include:

  • Trimethoprim
  • Sulfamethoxazole
  • Fosfomycin
  • Nitrofurantoin
  • Ciprofloxacin
  • Levofloxacin
  • Cephalexin
  • Ceftriaxone
  • Azithromycin
  • Doxycycline

Lifestyle and home remedies

Urinary tract infections can be painful, but you can take steps to ease your discomfort until antibiotics treat the infection. Follow these tips:

  • Drink plenty of water. Water helps to dilute your urine and flush out bacteria.
  • Avoid drinks that may irritate your bladder. Avoid coffee, alcohol, and soft drinks containing citrus juices or caffeine until your infection has cleared. They can irritate your bladder and tend to aggravate your frequent or urgent need to urinate.
  • Use a heating pad. Apply a warm, but not hot, heating pad to your abdomen to minimize bladder pressure or discomfort.

Prevention

You can take these steps to reduce your risk of urinary tract infections:

  • Drink plenty of liquids, especially water. Drinking water helps dilute your urine and ensures that you’ll urinate more frequently — allowing bacteria to be flushed from your urinary tract before an infection can begin.
  • Wipe from front to back. Doing so after urinating and after a bowel movement helps prevent bacteria in the anal region from spreading to the vagina and urethra.
  • Empty your bladder soon after intercourse. Also, drink a full glass of water to help flush bacteria.
  • Avoid potentially irritating feminine products. Using deodorant sprays or other feminine products, such as douches and powders, in the genital area can irritate the urethra.
  • Change your birth control method. Diaphragms, or unlubricated or spermicide-treated condoms, can all contribute to bacterial growth.

 

Categories
Disease & Condition

Tuberculosis

Tuberculosis (TB) is a potentially serious infectious disease that mainly affects your lungs. The bacteria that cause tuberculosis are spread from one person to another through tiny droplets released into the air via coughs and sneezes.

Symptoms

Signs and symptoms of active TB include:

  • Coughing that lasts three or more weeks
  • Coughing up blood
  • Chest pain, or pain with breathing or coughing
  • Unintentional weight loss
  • Fatigue
  • Fever
  • Night sweats
  • Chills
  • Loss of appetite

Tuberculosis can also affect other parts of your body, including your kidneys, spine or brain. When TB occurs outside your lungs, signs and symptoms vary according to the organs involved.

When to see a doctor

See your doctor if you have

  • fever
  • unexplained weight loss
  • drenching night sweats or a persistent cough

These are often signs of TB, but they can also result from other medical problems.

Risk factors

Anyone can get tuberculosis, but certain factors can increase your risk of the disease. These factors include:

Weakened immune system

A healthy immune system often successfully fights TB bacteria, but your body can’t mount an effective defense if your resistance is low. A number of diseases and medications can weaken your immune system, including:

  • HIV/AIDS
  • Diabetes
  • End-stage kidney disease
  • Certain cancers
  • Cancer treatment, such as chemotherapy
  • Drugs to prevent rejection of transplanted organs
  • Some drugs used to treat rheumatoid arthritis, Crohn’s disease and psoriasis
  • Malnutrition
  • Very young or advanced age

Traveling or living in certain areas

The risk of contracting tuberculosis is higher for people who live in or travel to countries that have high rates of tuberculosis and drug-resistant tuberculosis, such as:

  • Sub-Saharan Africa
  • India
  • China
  • Russia
  • Pakistan

Poverty and substance abuse

  • Lack of medical care.
  • Substance abuse.
  • Tobacco use.

Complications

  • Spinal pain. Back pain and stiffness are common complications of tuberculosis.
  • Joint damage. Tuberculous arthritis usually affects the hips and knees.
  • Swelling of the membranes that cover your brain (meningitis).
  • Liver or kidney problems.
  • Heart disorders.

Tests and diagnosis

During the physical exam, your doctor will check your lymph nodes for swelling and use a stethoscope to listen carefully to the sounds your lungs make while you breathe.

The most commonly used diagnostic tool for tuberculosis are

  • Tuberculin test.
  • Blood tests.
  • Imaging tests. If you’ve had a positive skin test, your doctor is likely to order a chest X-ray or a CT scan.
  • Sputum tests. If your chest X-ray shows signs of tuberculosis, your doctor may take samples of your sputum — the mucus that comes up when you cough. The samples are tested for TB bacteria. Sputum samples can also be used to test for drug-resistant strains of TB.

Treatments and drugs

The most common medications used to treat tuberculosis include:

  • Isoniazid
  • Rifampin
  • Ethambutol
  • Pyrazinamide

If you have drug-resistant TB, a combination of antibiotics called fluoroquinolones and injectable medications, such as amikacin, kanamycin or capreomycin, are generally used for 20 to 30 months.

Completing treatment is essential

After a few weeks, you won’t be contagious and you may start to feel better. It might be tempting to stop taking your TB drugs. But it is crucial that you finish the full course of therapy and take the medications exactly as prescribed by your doctor. Stopping treatment too soon or skipping doses can allow the bacteria that are still alive to become resistant to those drugs, leading to TB that is much more dangerous and difficult to treat.

To help people stick with their treatment, a program called directly observed therapy (DOT) is recommended. In this approach, a health care worker administers your medication so that you don’t have to remember to take it on your own.

Prevention

If you have active TB, keep your germs to yourself. It generally takes a few weeks of treatment with TB medications before you’re not contagious anymore. Follow these tips to help keep your friends and family from getting sick:

  • Stay home. Don’t go to work or school or sleep in a room with other people during the first few weeks of treatment for active tuberculosis.
  • Ventilate the room. Tuberculosis germs spread more easily in small closed spaces where air doesn’t move. If it’s not too cold outdoors, open the windows and use a fan to blow indoor air outside.
  • Cover your mouth. Use a tissue to cover your mouth anytime you laugh, sneeze or cough. Put the dirty tissue in a bag, seal it and throw it away.
  • Wear a mask. Wearing a surgical mask when you’re around other people during the first three weeks of treatment may help lessen the risk of transmission.