Dengue fever: Symptoms, Causes, Prevention and Treatment

DENGUE FEVER

DEFINITION: - Dengue fever is a mosquito-borne disease caused by four different viruses is that Dengue virus 1, 2, 3 and 4 and spread by Aedes mosquito which is found all over the world. The onset of the symptoms usually starts 4 to 7 days after the mosquito bite.

There is some research is on-going for developing the dengue vaccine. In some country vaccine for dengue fever are commercially available (the Philippines and Indonesia). So for the prevention of dengue fever, there is some method of preventing which we discuss in the separate heading in this blog.

There is gradually increasing in a number of dengue fever in India. Dengue fever in India 1^st reported in Madras in 1780 and the 1^st outbreak occurred in Calcutta in 1963. In India, dengue fever is more dangerous because there is lack of knowledge of sanitation and how to avoid further developing of dengue viruses and most common causes are that there are lots of open collection of water which are non-medicated that’s why there is friendly nature to produce more Aedes mosquito. So that’s why the spread of dengue virus is easy.

PATHOPHYSIOLOGY: - In this section, I will tell you how the dengue virus entre in our body and spread in a simple easy way to understand in a numerological way.

1.       1. Aedes mosquito with viruses bite person.

2.       2. Viruses enter in the skin with the saliva of mosquito.

3.      3. Both bind (viruses + saliva) and enter in white blood cell (WBC).

4.      4. In WBC they reproduce (increase number of viruses) while moving throughout the body.

5.      5. WBC respond by producing protein cells ( cytokines and interferons which are responsible for symptoms like fever and pain in the body)

6.      6. If treatment does not start at this stage than virus production increase greatly and more organs are affected and this is life-threatening.

SING AND SYMPTOMS: - Incubation period (time between exposure and onset of symptoms) 3 to 14 days

• Fever (sudden onset)
• A headache (behind eyes)
• Muscle pain
• Rush

There are three phase of sing and symptoms

The febrile phage: -In this phage, there is high-grade fever (40°C/104°F) and generalized body pain, headache, nausea, and vomiting are commonly present. Rush occur in 50 to 80% of cases. Rush resemble like measles describes an island of white in a sea of red. There is also mild bleeding occur in the mucous membrane of mouth and nose.

The critical phage: -In this phage, there is leakage of plasma from blood vessels resulting in fluid accumulation in the chest and abdominal cavity and decrease the volume of fluids from circulation decrease that’s why blood supply to the vital organ is decreased and that leads to organ dysfunction and severe bleeding. In this phage shock and hemorrhage occur in less than 5% of cases.

Recovery Phage: -In this phage, improvement is often striking and can be accompanied by itching and slow heart rate. There is also a feeling of fatigue.

Diagnosis

• CBC (decrease platelet count)
• Serological test for dengue ( IgG IgM)

PREVENTION

In dengue fever WHO recommended these five elements for integrated vector control program.

1. Advocacy, social mobilization and legislation to ensure public health bodies and community strengthened

2. Collaboration between health and other sectors.

3. An integrated approach to disease control to maximize use of resources.

4. Evidence-based decision making to ensure any intervention is targeted appropriately.

5. Capacity-building to ensure an adequate response to the local situation.

In short, reduce the open collection of water and if this is not possible than treat water with insecticides and biological control agents. Generalized spraying with organophosphate insecticides may help. Reducing open collection of water is best for controlling further spread of viruses. People can prevent of mosquito biting from wearing full sleeves shirts and pants, using mosquito net during rest. So this is some method to prevent dengue fever.

Vaccination

In Philippines and Indonesia, there is dengue vaccine is available for commercial use in 2006 and its cost about 207 us dollar (approx. 14466.20 rupees)

June 15 is celebrated as international anti-dengue day. Purpose of this celebration is to aware public about this fever and how to control.

TREATMENT

There is no any specific anti-viral drug for dengue fever. Most important is to maintain body fluid and symptomatic treatment. If you have high-grade fever than please consult your family physician for further treatment and diagnosis.

DR. AMIN I BAYAD

(BHMS)  

   

  

Typhoid Fever | Symptoms, treatment, causes, and prevention

TYPHOID FEVER

DEFINITION: - Typhoid fever is a systemic infectious disease caused by the bacterium Salmonella enterica serotype Typhi also known as s. typhi. Salmonella enterica serotype paratyphi( s. paratyphi) A, B, C cause the clinically similar condition known as paratyphoid. Typhoid and paratyphoid fever collectively referred to as enteric fever.

The contagious nature of the disease and incriminated faecally contaminated water sources in transmission was described by William Budd in 1873.

EPIDEMIOLOGY

India the typhoid fever is a major public health problem because of poor sanitation, lack of safe drinking water supply and low socioeconomic condition. That’s why in India there is lots of case of typhoid fever. The typhoid fever is usually observed throughout the year.

Age group: - mainly affect children and young adults

Gender: - more common in a male. As female are chronic carriers.

Socioeconomic factor: - Typhoid fever is a disease of poverty and associated with inadequate sanitation facilities and unsafe water supplies.

MODE OF TRANSMISSION

Typhoid fever is transmitted by the fecal-oral route, via contaminated food and water. Occasionally health care workers can acquire the disease from infected patients.

AETIOPATHOLOGY

I have lots of information regarding this section but as our motto is to explain in easy understand so I will briefly explain how bacteria enter in our bloodstream and produce typhoid fever as below,

S. Typhi is ingested with food and water (both contaminated).

Passes through the stomach and invade gut epithelium

In the small intestine invade and translocate to an intestinal lymphoid follicle

 

Some pass on to reticuloendothelial cells of liver and spleen

In the liver and spleen, they multiply

After 7 to 14 days of incubation clinical conditions such as fever appear

CLINICAL FEATURES

Prolonged fever: - initially low grade, rises progressively, and by the second week is often high and sustained. Continues fever rising in step-ladder fashion is observed

Fever including chills, headache, anorexia, cough, weakness, sore throat, dizziness, muscle pain and abdominal pain.

There are some physical sing present in typhoid fever such as coated tongue, tender abdomen, hepatomegaly and/or splenomegaly may be found.

In some patient at the end of 1^st week small maculopapular, blanching and erythematous rush typically on trunk and chest may be seen.

Constipation may present in some patient

DIAGNOSIS

Typhoid should be considered in any patient with prolonged unexplained fever with an appearance of a rose spot.

Complete blood count

Widal test is the best serological test to diagnose typhoid fever

COMPLICATION

The commonest complication is as follow

Intestinal perforation

Gastrointestinal hemorrhage

Typhoid encephalopathy

PROGNOSIS

When untreated the fever persists for 2 weeks or more and defervescence occurs slowly over the following 2 to 3 weeks. Death occurs in between 10% to 30%  of an untreated patient following complication.

PREVENTION

We can prevent typhoid fever by improving sanitation, ensuring the safety of food and water supplies, identification and treatment of chronic carries of s.typhi, and use of typhoid vaccines to reduce the susceptibility of the host to infection.

Vaccination is recommended for use in travelers to endemic areas, for household contact of typhoid carries, and laboratory workers.

There are two type of vaccine available for typhoid fever

1 Parenteral Vi polysaccharide vaccine.

2 Oral Vaccine ( S. Typhi strain Ty21a is live attenuated oral vaccine)

TREAMENT

General Management

Supportive measures such as adequate rest, tepid bath and sponging, appropriate nutrition and diet, all are important in the management of typhoid fever.

Anti-microbial therapy

There are many medicines to treat typhoid fever but without consultation with your family physician, you cannot use any antibiotics. If you have high-grade fever since 7 to 10 days without any relief in symptoms please consult your family physician for proper treatment

Dr. Amin I Bayad

(BHMS)

   

  

What are the main causes of kidney stones?

KIDNEY STONE

Definition: - Kidney stone is also known as urolithiasis. When a solid piece of material is conjugated in one or both of your kidney because of the high level of the certain mineral are in urine and that conjugated piece is called kidney stone.

Kidney stone is varying in size. Small size stone may pass without any medication and without any causing sing and symptoms. When stones size is more than 5mm are difficult to pass and can causes severe pain and block ureter. Stone are form in kidney when minerals are high in concentration.

Pathophysiology (How kidney stone form?)

Hypocitraturia: - The meaning of hypocitraturia is citrate excretion less than 320 mg/day in urine Hypocitraturia can causes formation of kidney stone because role of citrate is to reduce super saturation of calcium salt and inhibits crystal growth (stone).

Inhibitors of stone formation: - Normal urine contain chelating agent such as citrate, calgronal, tamm-harshfall protein, uroprotin, nephrocalcium, prothrombin peptide and bikuni. All of the above are chelating agent (inhibits the formation of kidney stone) If this all chelating agent are less in concentration than there is increase the chance of formation of kidney stone.

Sufficient intake of citrate and magnesium inhibits the formation of kidney stone.

Type of kidney stone

On the basis of type of kidney stone we can determine the cause and its help to prevent further formation of kidney stone.

Calcium stone: - This is the most common type of stone in the form of calcium oxalate.Oxalate is natural substance found in foods such as fruits, vegetables, nuts, and chocolate this all are have high concentration of oxalate. And also made by our liver daily. Oxalate may occur in form of phosphate. And this calcium phosphate devolve by metabolic disorder.

Struvite stone: - Stone which form by infection is called struvite stone. Infection such as UTI. This type of stone can grow quick and larger than other stone.

Uric acid stone: - Uric acid stone are mainly form in those people who don’t drink enough Fluid or who lose too much fluid are more prone to develop uric acid stone. Person on high protein diet and have disorder of gout are also more prone to develop uric acid stone

Cysteine stone: - Kidney that excrete too much of amino acid can form this type of kidney Stone. This type of stone can also see in hereditary disorder.

Risk Factor

Family history/ Personal history: - If someone has kidney stone in your family than you are more prone to develop kidney stone. If you have history of kidney stone than there is increase chance of reoccurrence

Diet: - Person who takes high protein diet, sodium, and sugar in food is higher risk to develop kidney stone. Too much salt in diet can increase amount of calcium.

Dehydration: - Person who not drinking enough water lead to formation of kidney stone. Person who live in warm climate and who sweat a lot that all are high risk of developing kidney stone.

Digestive Disease: - Irritable bowel disease, chronic diarrhoea both this disease can alter the digestive system and can cause increase loss of fluids and increase absorption of calcium so that lead to increase concentration of calcium in blood stream and form kidney stone.

Obese: - person who high BMI, larger Waist size are higher risk of kidney stone.

Surgery: - Gastric bypass surgery are one of factor to developing kidney stone.

Symptoms

 Small size of stone may pass without causing any symptoms but if the size of stone is larger (more than 5mm) can produce symptoms which are as below.

• Severe pain at side of abdomen and back
• Pain is radiate to lower abdomen
• Kidney stone pain is wave in nature (come and go)
• Urine burning
• Pain during urination
• Colour of urine- Red, pink, browen
• Smell of urine- foul
• Nausea and vomiting
• Urge of urine increase but when urinate urine come with drop by drop
• Fever and chill if there is infection present(UTI)

Diagnosis

Blood

Urine routine, micro, culture

X-Ray

USG

CT-Scan

Prevention

 There are some tips to prevent developing of kidney stone.

Drink plenty of water: - people who have history of stone are recommending drinking plenty of water. If you urine colour is dark yellow than there is sing of you are tacking less water than you need. When we take plenty of water colour of urine is light yellow and clear.

Foods: - Avoid Oxalate rich food such as rhubarb, beats, okra, spinach, sweet potatoes, nuts, tea, chocolates, black paper etc.

Low slat diet

Avoid calcium supplements

Take leman water daily, you can also take coconut water.

Treatment

If you have kidney stone less than 5mm than there is no need of medication only plenty of water, leman water, is enough to pass kidney stone. But size of stone is more than 5mm than you need medication so please consult your physician as soon as possible. If you want online consultation contact me.

Homeopathic treatment for kidney stone

There is wonderful remedy in homeopathy which not only treat but prevention of further developing of kidney stone. I have my own preparation for kidney stone which gives wonderful result in some case its take less than 24 hour to remove stone from kidney. If you want some preparation contact me through email.  

Dr. Amin I Bayad

(BHMS)